Study onpredisposing factors for fungal infection after endoscopic treatment of variceal bleeding in liver cirrhosis
LIU Fenxia
GUO Guanya
NIE Yan
Abstract：Objective To investigate the predisposing factors for fungal infections in patients with liver cirrhosis and esophagogastric variceal bleeding(EGVB)after endoscopic treatment.Methods Fifteen patients with cirrhosis who devel-oped fungal infections after endoscopic treatment for esophagogastric variceal bleeding(EGVB)were retrospectively select-ed from the First Affiliated Hospital of Air Force Medical University(January 2019 to September 2024)as the infection group,and 65 patients with cirrhosis who underwent EGVB endoscopic treatment without infections during the same peri-od were randomly selected as the non-infection group.Clinical data from both groups were collected,and multivariate lo-gistic regression analysis was used to identify predisposing factors.The predictive value was assessed using receiver operat-ing characteristic(ROC)curves,and a decision tree model was constructed.Results Among the 15 patients with fungal infections after endoscopic treatment,16 fungal strains were detected,with Candida albicans being the most prevalent(7 strains,43.75%).Additionally,13 strains(81.25%)were isolated from sputum/bronchoalveolar lavage fluid.Logistic regression analysis revealed that age,hospitalization duration,Child-Pugh classification of liver function,hepatic encepha-lopathy,and long-term use of broad-spectrum antibiotics were predisposing factors for fungal infections after endoscopic treatment in EGVB patients(P<0.05),while albumin and serum 25-hydroxyvitamin D3[25-(OH)D3]were protective factors(P<0.05).ROC curve analysis showed that the above indicators and their combined prediction were statistically significant for predicting fungal infections after endoscopic treatment(P<0.05).The combined prediction had an area un-der the curve(AUC)of 0.999(95%CI:0.996～1.000),with a sensitivity of 1.000 and specificity of 0.985,indicating higher predictive value.The decision tree model identified age as the most significant predictor,with a classification accura-cy of 100%.Conclusion Age,hospitalization duration,Child-Pugh classification of liver function,hepatic encephalopathy,and long-term use of broad-spectrum antibiotics are predisposing factors for fungal infections after endoscopic treatment in EGVB patients,while albumin and 25-(OH)D3 are protective factors.Clinicians should assess these related factors and im-plement targeted preventive measures.
Keywords：liver cirrhosisesophagogastric variceal bleedingendoscopic treatmentfungal infectionpredisposing factorssafeguard procedures
Publication Date：2025-10-28
Online Publishing Date：2025-11-19(First online date of this platform, not the publication date of the document)
Pages：6( 477-482 )