2025年平等肺囊虫评分-一个ECMM工具衡量肺囊虫肺炎管理的质量。

IF 3.3 Q2 INFECTIOUS DISEASES
JAC-Antimicrobial Resistance Pub Date : 2025-09-29 eCollection Date: 2025-10-01 DOI:10.1093/jacamr/dlaf165
Luise Haensel, Rosanne Sprute, Jan Grothe, Florence Robert-Gangneux, Jean-Pierre Gangneux, Jacques F Meis, Oliver A Cornely, Philipp Koehler
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引用次数: 0

摘要

背景:肺囊虫肺炎(PCP)是一种机会性真菌感染。已经发表了一些指导方针来支持其临床管理。然而,这些指南的复杂性和广度对在常规临床实践中一致实施提出了挑战。目的:开发一种评分工具和质量指标,以促进临床决策并量化艾滋病毒感染者和非艾滋病毒感染者PCP最佳实践指南的遵守情况。方法:从欧洲白血病感染理事会(ECIL)、美国移植传染病实践协会(AST-IDCOP)和IDSA指南中提取诊断、治疗和随访PCP的关键建议。每个建议被赋予一个从-1到3的分值,根据建议的强度和证据水平加权。结果:拟议的2025年欧洲医学真菌学联合会(ECMM)质量(EQUAL)肺囊虫评分包括24项HIV患者和22项非HIV患者。在诊断方面,支气管肺泡灌洗法和免疫荧光法因其取样和分析的敏感性和特异性较好而获得最高分。甲氧苄啶/磺胺甲恶唑是首选的治疗方法,得分最高。对艾滋病毒和呼吸衰竭患者添加皮质类固醇使治疗类别更加完善。该评分在患者随访时完成。艾滋病毒患者的最高得分为31分,非艾滋病毒患者的最高得分为27分。结论:2025年EQUAL肺囊虫评分为PCP的优化管理提供了一个简明、循证的工具。这可以在日常实践中用于快速概述,并可用于衡量研究设置的指南依从性。目前尚未评估更高的EQUAL肺囊虫评分是否与患者预后改善有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The 2025 EQUAL Pneumocystis Score-an ECMM tool to measure QUALity in Pneumocystis pneumonia management.

Background: Pneumocystis pneumonia (PCP) is an opportunistic fungal infection. Several guidelines have been published to support its clinical management. However, the complexity and breadth of these guidelines pose challenges for consistent implementation in routine clinical practice.

Objectives: To develop a scoring tool and quality indicator that facilitates clinical decision making and quantifies adherence to best-practice guidelines for PCP in patients with and without HIV.

Methods: Key recommendations for the diagnosis, treatment and follow-up of PCP were extracted from current guidelines of the European Council on Infections in Leukaemia (ECIL), the American Society of Transplantation Infectious Diseases Community of Practice (AST-IDCOP), and the IDSA guidelines. Each recommendation was assigned a point value ranging from -1 to 3, weighted according to the strength of recommendation and level of evidence.

Results: The proposed 2025 European Confederation of Medical Mycology (ECMM) QUALity (EQUAL) Pneumocystis Score consists of 24 items for patients with HIV and 22 for patients without HIV. For diagnosis, bronchoalveolar lavage and immunofluorescence assays received the highest scores due to their superior sensitivity and specificity for sampling and analysis. Trimethoprim/sulfamethoxazole is the treatment of choice and was awarded with the highest score. The addition of corticosteroids for patients with HIV and respiratory failure completes the treatment category. The score is completed with the patient follow-up. For HIV patients a maximum score of 31 and for non-HIV patients a maximum score of 27 is achievable.

Conclusions: The 2025 EQUAL Pneumocystis Score offers a concise, evidence-based tool for the optimal management of PCP. This can be useful in daily practice for a quick overview and may be used to measure guideline adherence in research settings. It has not yet been assessed whether higher EQUAL Pneumocystis Scores are associated with improved patient outcomes.

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