摘要
Abstract
Objective To explore the risk factors for fungal infections in female patients with pelvic abscesses and evaluate the predictive efficacy of each factor.Methods This study was a prospective,observational study.A total of 255 female patients with pelvic abscesses who were hospitalized in the Department of Obstetrics and Gynecology of Wuhan No.1 Hospital from February 2021 to January 2025 were enrolled as the research subjects.The enrolled patients were divided into a group with concurrent fungal infection and a group without concurrent fungal infection according to whether they had a concurrent fungal infection during the treatment process.The differences in general clinical data,factors related to pelvic abscesses,treatment-related factors,and routine laboratory test indicators between the two groups of patients were compared.Multivariate logistic regression analysis was used to screen the independent influencing factors related to the risk of concurrent fungal infection in female patients with pelvic abscesses.The receiver operating characteristic(ROC)curve was plotted to analyze the value of the combined prediction of concurrent fungal infection in patients by each influencing factor.Results The age range of the enrolled female patients with pelvic abscesses was 23 to 69 years old,and the median age was 42(37,50)years old.Among them,44 cases had concurrent fungal infections,and the incidence of concurrent fungal infections was 17.3%.The age,proportion of patients with diabetes mellitus,proportion of patients with malnutrition,maximum body temperature,abscess size,course of disease,proportion of patients using glucocorticoids,proportion of patients using sex hormone drugs,proportion of patients with indwelling urinary catheters,duration of antibiotic use,types of antibiotics used,proportion of carbapenem use,neutrophil count before treatment,C-reactive protein,procalcitonin and erythrocyte sedimentation rate(ESR)in the group with concurrent fungal infection were all higher than those in the group without concurrent fungal infection,while the albumin(ALB)and IgG were lower than those in the group without concurrent fungal infection(P＜0.05).Multivariate logistic regression analysis indicated that age,malnutrition,abscess size,use of glucocorticoids,duration of antibiotic use,types of antibiotics used,neutrophil count,and ESR were all independent risk factors for the risk of concurrent fungal infection in female patients with pelvic abscesses,and IgG was an independent protective factor for the risk of concurrent fungal infection in female patients with pelvic abscesses(P＜0.05).ROC curve analysis showed that the area under the curve(95%CI)of the combined prediction of the risk of concurrent fungal infection in female patients with pelvic abscesses by the above 9 influencing factors was 0.847(0.785-0.909),with a sensitivity of 84.53%and a specificity of 80.25%.Conclusion Age,malnutrition,abscess size,use of glucocorticoids,antibiotic use,neutrophil count,ESR,and IgG are all influencing factors for concurrent fungal infection in female patients with pelvic abscesses.Based on the above indicators,the risk of concurrent fungal infection in patients can be effectively predicted.关键词
盆腔脓肿/真菌感染/危险因素Key words
pelvic abscess/fungal infection/risk factors
