{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:07:46Z","timestamp":1785420466844,"version":"3.56.0"},"reference-count":37,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006765","name":"Chinese Medical Association","doi-asserted-by":"crossref","award":["Z-2017-24-2202"],"award-info":[{"award-number":["Z-2017-24-2202"]}],"id":[{"id":"10.13039\/501100006765","id-type":"DOI","asserted-by":"crossref"}]},{"award":["Z-2017-24-2202"],"award-info":[{"award-number":["Z-2017-24-2202"]}],"id":[{"id":"https:\/\/ror.org\/044fynn32","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Beijing Pharmaceutical Association Clinical Pharmacy Research Project","award":["LCYX-2026-11"],"award-info":[{"award-number":["LCYX-2026-11"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Fungi","JoF"],"abstract":"<jats:p>Non-HIV Pneumocystis jirovecii pneumonia (PJP) is a life-threatening opportunistic fungal pneumonia that may progress rapidly in immunocompromised hosts. Broad bronchoalveolar lavage fluid (BALF) molecular testing supports microbiologic recognition, but additional organisms often require bedside adjudication. We conducted a single-center observational study of 49 HIV-negative adults with clinically confirmed PJP, routine BALF metagenomic next-generation sequencing support, and complete 30-day follow-up. Diagnosis required compatible symptoms and chest computed tomography findings, microbiologic support for P. jirovecii, and infectious disease specialist exclusion of isolated colonization. The primary endpoint was ICU-level care requirement, defined as ICU admission, invasive mechanical ventilation, or 30-day all-cause mortality. Recent immunosuppressive exposure was present in 48 patients (98.0%). ICU-level care was required in 15 patients (30.6%); all ventilation and death events occurred in this group, and 30-day mortality was 10.2%. Baseline PaO2\/FiO2 &lt; 200 mmHg was associated with higher proportions of ICU admission, mechanical ventilation, and death. Chronic kidney disease, lower creatinine clearance, higher lactate dehydrogenase, and bacterial co-pathogen context showed exploratory signals, whereas overall co-pathogen positivity was heterogeneous. These findings support integrating oxygenation status, host vulnerability, and conservative co-pathogen adjudication to guide escalation and antimicrobial decisions after BALF testing.<\/jats:p>","DOI":"10.3390\/jof12070541","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T13:25:46Z","timestamp":1784726746000},"page":"541","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oxygenation-Based Severity Stratification and a Proposed Clinical Diagnostic Workflow for Non-HIV Pneumocystis jirovecii Pneumonia: A Single-Center Observational Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2305-3215","authenticated-orcid":false,"given":"Jing","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Fuzhou Second General Hospital, Fuzhou 350007, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhonghua","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingqiu","family":"Ying","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2487","DOI":"10.1056\/NEJMra032588","article-title":"Pneumocystis pneumonia","volume":"350","author":"Thomas","year":"2004","journal-title":"N. 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