Protocol for the systematic review of the Pneumocystis jirovecii-associated pneumonia in non-HIV immunocompromised patients

• Published in: PloS one 2024-05, Vol.19 (5), p.e0302055-e0302055
• Main Authors: Orozco-Ugarriza, Mauricio Ernesto, Olivo-Martínez, Yenifer, Rodger-Cervantes, Yuranis E
• Format: Article
• Language: English
• Subjects: Analysis; Antiviral agents; Autoimmune diseases; Bacterial pneumonia; Biology and Life Sciences; Cancer; Care and treatment; Chemotherapy; Diagnosis; Disease prevention; Dosage and administration; Drug dosages; Epidemiology; Evidence-based medicine; Health aspects; Hematology; Heterogeneity; HIV; HIV (Viruses); HIV patients; Human immunodeficiency virus; Humans; Immune system; Immunocompromised Host; Immunocompromised hosts; Immunosuppressive agents; Immunotherapy; Infections; Inflammatory diseases; Literature reviews; Medical research; Medicine and Health Sciences; Medicine, Experimental; Meta-analysis; Microbiology; Mortality; Opportunist infection; Organisms; Pathogenesis; Pathogens; Patient outcomes; Patients; Pneumocystis carinii - pathogenicity; Pneumocystis carinii pneumonia; Pneumocystis jirovecii; Pneumonia; Pneumonia, Pneumocystis - diagnosis; Pneumonia, Pneumocystis - drug therapy; Pneumonia, Pneumocystis - immunology; Pneumonia, Pneumocystis - microbiology; Prophylaxis; Registered Report Protocol; Research and Analysis Methods; Risk factors; State-of-the-art reviews; Steroid hormones; Steroids; Synthesis; Systematic review; Systematic Reviews as Topic
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0302055

Pneumocystis jirovecii pneumonia (PJP) is a well-known and frequent opportunistic infection in HIV patients. However, there has been an increase in the number of reports of PJP in other immunosuppressed patients with autoimmune inflammatory disorders or because of chemotherapy and high doses of steroids, especially when used in combination as part of immunosuppressive therapy. Despite the increasing importance of PJP in non-HIV patients, there is a lack of comprehensive and updated information on the epidemiology, pathogenesis, diagnosis, microbiology, treatments, and prophylaxis of this infection in this population. Therefore, the objective of this systematic review is to synthesize information on these aspects, from a perspective of evidence-based medicine. The protocol is prepared following the preferred reporting items for systematic reviews and meta-analyses (PRISMA-P) guidelines. We will perform a systematic review of literature published between January 2010 and July 2023, using the databases PubMed, Google Scholar, ScienceDirect, and Web of Science. In addition, manual searches will be carried out through related articles, and references to included articles. The main findings and clinical outcomes were extracted from all the eligible studies with a standardized instrument. Two authors will independently screen titles and abstracts, review full texts, and collect data. Disagreements will be resolved by discussion, and a third reviewer will decide if there is no consensus. We will synthesize the results using a narrative or a meta-analytic approach, depending on the heterogeneity of the studies. It is expected that this systematic review will provide a comprehensive and up-to-date overview of the state-of-the-art of PJP in non-HIV patients. Furthermore, the study will highlight possible gaps in knowledge that should be addressed through new research. Here, we present the protocol for a systematic review which will consider all existing evidence from peer-reviewed publication sources relevant to the primary and secondary outcomes related to diagnosing and managing PJP in non-HIV patients.