Correlation factors of fungal infection in patients with digestive tract malignancies during chemotherapy

DANG Limei; LUO Bing

doi:10.3969/j.issn.1673-3827.2025.04.005

Abstract：Objective To investigate the correlation factors of fungal infection(FI)in patients with digestive tract malig-nancies during chemotherapy.Methods 57 patients with FI during chemotherapy for digestive tract malignant tumors from March 2023 to September 2024 in the Department of Gastroenterology of the First Affiliated Hospital of Air Force Military Medical University were selected as FI group,and 103 patients without FI during chemotherapy for digestive tract malignant tumors during the same period were selected as non-FI group.The distribution and drug resistance of FI were analyzed.Clinical data were collected,and logistic regression analysis was performed to identify factors affecting FI occurrence during chemotherapy.A FI regression prediction model was constructed based on these factors,and its predictive value,goodness of fit,and consistency were evaluated.Results 62 strains of fungi were isolated by fungal culture identification,including Candida albicans(45.16%),C.glabrata(32.26%),C.tropicalis(12.90%),and C.krusei(9.68%).The 62 fungal strains showed varying degrees of drug resistance.Except for C.krusei's natural resistance to fluconazole,C.albicans,C.glabrata,and C.tropicalis showed certain resistance rates to ketoconazole and miconazole.Logistic regression analysis re-vealed that age(OR=2.469,95%CI=1.184-5.147),history of fungal infection(OR=3.137,95%CI=1.361-7.229),comorbid diabetes(OR=3.245,95%CI=1.139-9.243),long-term use of glucocorticoids(OR=4.198,95%CI=1.085-16.246),types of antibiotics used(OR=4.418,95%CI=1.069-18.256),and presence of malnutrition(OR=8.834,95%CI=2.074-37.625)were influencing factors for FI during chemotherapy.The regression prediction model constructed based on these factors showed an area under curve(AUC)of 0.726 in receiver operating characteristic curve(ROC)analysis.Hos-mer-Lemeshow test showed no overfitting,and internal validation demonstrated good consistency.Conclusions Fungal in-fections during chemotherapy in patients with digestive tract malignancies are primarily caused by C.albicans and C.gla-brata.Age,history of fungal infection,comorbid diabetes,long-term use of glucocorticoids,types of antibiotics used,and presence of malnutrition can affect the occurrence of FI.The regression prediction model based on these factors shows good predictive performance and can provide reference for clinical prevention and management.