Outcomes of concomitant PJP and CMV infection in non-HIV, critically ill patients

<bold>Introduction:</bold> Pneumocystis jirovecii pneumonia(PCP) is a potentially life-threatening opportunistic infection. Recent study demonstrated poor prognosis and higher mortality rate in non-HIV patient, associated risk factor included cytomegalovirus(CMV) co-infection. We aimed to investigate the manifestation and outcomes of concomitant PJP and CMV infection in non-HIV, critically ill patients. <bold>Method:</bold> We had retrospectively collected patients with all adult patients who admitted to intensive care unit(ICU) and diagnosed with PCP infection from January 2017 and December 2022. The data were retrieved from the Chang Gung Research Database, including clinical manifestations, comorbidities and mortality. <bold>Result:</bold> A total of 1597 adult patients who admitted in ICU with mechanical ventilator use having bronchoalveolar lavage (BAL) evaluation were enrolled. There 289 patients had PCP infection (18%). Among them, 26 patients had concomitant CMV infection, while there were 28 patients in the non-PCP infection group had CMV infection (19.7% versus 6.7%). Increased incidence of septic shock was noticed in CMV co-infection group (26.9% vs. 5.7%, p= 0.004). There was no difference between APACHE II score and PaO2/FiO2 ratio among them. In-patient mortality was significantly higher in PCP with CMV co-infection group (33.3% vs. 11.1%, P=0.002). <bold>Conclusions:</bold> Concomitant CMV infection was common in non-HIV, critically ill patient with PCP infection, and was associated worse outcome. Early recognition and treatment may improve outcomes.