Study on risk factors associated with peptic ulcer combined with fungal infection in children

ZHONG Yanling; ZHU Xiaoqin; Luo Xiaoxue; Hu Ziyang

doi:10.3969/j.issn.1673-3827.2026.01.003

Abstract：Objective To investigate the risk factors associated with peptic ulcer(PU)combined with fungal infections in children and the application of targeted protective measures.Methods A retrospective study was conducted involving 21 children with peptic ulcer and fungal infection(infection group)and 63 matched non-infected peptic ulcer controls(1∶3 ratio)admitted between February 2023 and February 2025.Clinical data were collected,and risk factors for fungal infection were identified using multivariable logistic regression.Predictor accuracy was evaluated via ROC analysis,and a decision tree model was constructed based on the identified factors.Targeted protective interventions were implemented,and changes in eating behavior were assessed using the SCEBS score before and after intervention.Results A total of 26 strains of fungi were detected in 21 children with PU combined with fungal infections in this study,of which 22 strains of Candida albicans(84.62%)were predominant.The results of multifactorial logistic regression showed that ulcer maximum diameter,hospital stay(>15 d),combination of more than 2 antimicrobial drugs,application of broad-spectrum antimicrobial drugs for>2 weeks,and CRP were the independent risk factors for PU-combined fungal infections(P<0.05).AUC=0.998,95%CI(0.994-1.000)for the joint test revealed that the following factors as ulcer maximum diameter,hospital stay(>15 d),combination of more than two antimicrobial drugs,application of broad-spectrum antimicrobial drugs>2 weeks,CRP,and joint prediction of PU combined with fungal infection were statistically significant(P<0.05)according to ROC analysis.Of these,CRP was the most significant predictor,and the model's classification accuracy was 100.00%.After four weeks of intervention,children with peptic ulcer complicated with fungal infection had higher SCEBS scores than they had before,and the difference was statistically significant(P<0.05).Conclusion C.albicans is the main causative species of fungal infections in children with PU,and the maximum diameter of ulcers,length of hospitalisation(>15 d),use of more than 2 antimicrobial drugs,application of broad-spectrum antimicrobial drugs for>2 weeks,and CRP are important risk factors for fungal infections in children with PU.Clinical attention should be paid to the early conduct of drug sensitivity tests and selection of antimicrobial drugs according to the results,so as to provide children with targeted measures of protection,in order to improve the clinical symptoms and promote the recovery of children.