Increasing Pneumocystis pneumonia, England, UK, 2000-2010

Abstract

After an increase in the number of reported cases of Pneumocystis jirovecii pneumonia in England, we investigated data from 2000-2010 to verify the increase. We analyzed national databases for microbiological and clinical diagnoses of P. jirovecii pneumonia and associated deaths. We found that laboratory-confirmed cases in England had increased an average of 7% per year and that death certifications and hospital admissions also increased. Hospital admissions indicated increased P. jirovecii pneumonia diagnoses among patients not infected with HIV, particularly among those who had received a transplant or had a hematologic malignancy. A new risk was identified: preexisting lung disease. Infection rates among HIV-positive adults decreased. The results confirm that diagnoses of potentially preventable P. jirovecii pneumonia among persons outside the known risk group of persons with HIV infection have increased. This finding warrants further characterization of risk groups and a review of P. jirovecii pneumonia prevention strategies.

Keywords: England; P. jirovecii pneumonia; Pneumocystis jirovecii; fungi; pneumonia; respiratory infections; surveillance.

Figure 1

Pneumocystis jirovecii infections reported by national data collection systems, England, UK, 2000–2010. Hospital admissions exclude patients with HIV diagnoses.

Figure 2

Age and sex distribution of patients with Pneumocystis jirovecii infections (excluding HIV-infected patients) among hospital admissions, England, UK, 2000–2010.

Figure 3

Pneumocystis jirovecii infections and deaths among persons with diagnosed HIV infection, England, UK, 2000–2010.