. 2024 Jun 27;62(6):myae038.

doi: 10.1093/mmy/myae038.

Features and global impact of invasive fungal infections caused by Pneumocystis jirovecii: A systematic review to inform the World Health Organization fungal priority pathogens list

Brendan McMullan^{1

2}, Hannah Yejin Kim^{3

4

5}, Ana Alastruey-Izquierdo⁶, Evelina Tacconelli⁷, Aiken Dao^{5

8}, Rita Oladele⁹, Daniel Tanti^{2

10}, Nelesh P Govender^{11

12

13

14}, Jong-Hee Shin¹⁵, Jutta Heim¹⁶, Nathan Paul Ford^{17

18}, Benedikt Huttner¹⁹, Marcelo Galas²⁰, Saskia Andrea Nahrgang²¹, Valeria Gigante²², Hatim Sati²², Jan Willem Alffenaar^{3

4

5}, C Orla Morrissey^{23

24}, Justin Beardsley^{5

8}

Affiliations

¹ Faculty of Medicine and Health, UNSW, Sydney, New South Wales, Australia.
² Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Sydney, New South Wales, Australia.
³ Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.
⁴ Department of Pharmacy, Westmead Hospital, Western Sydney LHD, North Parramatta, New South Wales, Australia.
⁵ Sydney Infectious Diseases Institute, The University of Sydney, Camperdown, New South Wales, Australia.
⁶ Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
⁷ Department of Diagnostics and Public Health, Verona University, Verona, Italy.
⁸ Westmead Hospital, Western Sydney LHD, North Parramatta, New South Wales, Australia.
⁹ Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria.
¹⁰ Discipline of Paediatrics, Faculty of Medicine and Health, University of NSW, Sydney, Australia.
¹¹ Division of the National Health Laboratory Service, National Institute for Communicable Diseases, Johannesburg, South Africa.
¹² Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹³ Institute of Infection and Immunity, St George's University of London, London, UK.
¹⁴ MRC Centre for Medical Mycology, University of Exeter, Exeter, UK.
¹⁵ Department of Laboratory Medicine, Chonnam National University School of Medicine, Gwangju, South Korea.
¹⁶ Scientific Advisory Committee, Helmholtz Centre for Infection Research, Germany.
¹⁷ Department of HIV, Viral Hepatitis and STIs, World Health Organization, Geneva, Switzerland.
¹⁸ Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
¹⁹ Essentials Medicines List Team, WHO, Geneva, Switzerland.
²⁰ Antimicrobial Resistance Special Program, Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization, Washingdom, District of Columbia, USA.
²¹ Antimicrobial Resistance Programme, World Health Organization European Office, Copenhagen, Denmark.
²² AMR Division, WHO, Geneva, Switzerland.
²³ Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia.
²⁴ Department of Infectious Diseases, Monash University, Clayton, Victoria, Australia.

PMID: 38935910
PMCID: PMC11210620
DOI: 10.1093/mmy/myae038

Features and global impact of invasive fungal infections caused by Pneumocystis jirovecii: A systematic review to inform the World Health Organization fungal priority pathogens list

Brendan McMullan et al. Med Mycol. 2024.

. 2024 Jun 27;62(6):myae038.

doi: 10.1093/mmy/myae038.

Authors

Affiliations

¹ Faculty of Medicine and Health, UNSW, Sydney, New South Wales, Australia.
² Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Sydney, New South Wales, Australia.
³ Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.
⁴ Department of Pharmacy, Westmead Hospital, Western Sydney LHD, North Parramatta, New South Wales, Australia.
⁵ Sydney Infectious Diseases Institute, The University of Sydney, Camperdown, New South Wales, Australia.
⁶ Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
⁷ Department of Diagnostics and Public Health, Verona University, Verona, Italy.
⁸ Westmead Hospital, Western Sydney LHD, North Parramatta, New South Wales, Australia.
⁹ Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria.
¹⁰ Discipline of Paediatrics, Faculty of Medicine and Health, University of NSW, Sydney, Australia.
¹¹ Division of the National Health Laboratory Service, National Institute for Communicable Diseases, Johannesburg, South Africa.
¹² Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹³ Institute of Infection and Immunity, St George's University of London, London, UK.
¹⁴ MRC Centre for Medical Mycology, University of Exeter, Exeter, UK.
¹⁵ Department of Laboratory Medicine, Chonnam National University School of Medicine, Gwangju, South Korea.
¹⁶ Scientific Advisory Committee, Helmholtz Centre for Infection Research, Germany.
¹⁷ Department of HIV, Viral Hepatitis and STIs, World Health Organization, Geneva, Switzerland.
¹⁸ Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
¹⁹ Essentials Medicines List Team, WHO, Geneva, Switzerland.
²⁰ Antimicrobial Resistance Special Program, Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization, Washingdom, District of Columbia, USA.
²¹ Antimicrobial Resistance Programme, World Health Organization European Office, Copenhagen, Denmark.
²² AMR Division, WHO, Geneva, Switzerland.
²³ Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia.
²⁴ Department of Infectious Diseases, Monash University, Clayton, Victoria, Australia.

PMID: 38935910
PMCID: PMC11210620
DOI: 10.1093/mmy/myae038

Abstract

This systematic review evaluates the current global impact of invasive infections caused by Pneumocystis jirovecii (principally pneumonia: PJP), and was carried out to inform the World Health Organization Fungal Priority Pathogens List. PubMed and Web of Science were used to find studies reporting mortality, inpatient care, complications/sequelae, antifungal susceptibility/resistance, preventability, annual incidence, global distribution, and emergence in the past 10 years, published from January 2011 to February 2021. Reported mortality is highly variable, depending on the patient population: In studies of persons with HIV, mortality was reported at 5%-30%, while in studies of persons without HIV, mortality ranged from 4% to 76%. Risk factors for disease principally include immunosuppression from HIV, but other types of immunosuppression are increasingly recognised, including solid organ and haematopoietic stem cell transplantation, autoimmune and inflammatory disease, and chemotherapy for cancer. Although prophylaxis is available and generally effective, burdensome side effects may lead to discontinuation. After a period of decline associated with improvement in access to HIV treatment, new risk groups of immunosuppressed patients with PJP are increasingly identified, including solid organ transplant patients.

Keywords: Pneumocystis jirovecii; PCP; immunosuppression; invasive fungal infection; pneumonia.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1.**
Flow diagram for the selection of studies included in the systematic review. Based on Page et al..

See this image and copyright information in PMC

References

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1. Alanio A, Bretagne S. Pneumocystis jirovecii detection in asymptomatic patients: what does its natural history tell us?. F1000Res. 2017; 6: 739. - PMC - PubMed
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Features and global impact of invasive fungal infections caused by Pneumocystis jirovecii: A systematic review to inform the World Health Organization fungal priority pathogens list

Affiliations

Features and global impact of invasive fungal infections caused by Pneumocystis jirovecii: A systematic review to inform the World Health Organization fungal priority pathogens list

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous