Characteristics of invasive fungal infections in obstetric and gynecologic patients

<正>Objective:To investigate the diagnosis and treatment of invasive fungal infections(IFI) in the patients admitted to the Department of Obstetrics and Gynecology in Peking Union Medical College Hospital(PUMCH). Methods:The IFI data from the clinical laboratory and medical records of PUMCH from January,2003 to December, 2009 were studied retrospectively.The patients were classified by diagnostic criteria as confirmed,clinical-diagnosed or suspected cases,and classified by treatment protocols into surgery,chemotherapy or end-stage of malignant tumors.The distribution,pathogens,risk factors and treatment outcomes of IFIs in these patients were discussed. Results:The data of 220 obstetric-gynecologic cases of IFIs were retrieved(52 cases confirmed,11 clinical-diagnosed and 157 suspected).The incidence of confirmed urinogenital IFIs in obstetric-gynecologic patients was greater than overall incidence of urinogenital IFIs in PUMCH(46.2%vs.18.7%,P<0.001).The possible risk factors of IFIs in the obstetric-gynecologic patients included hypoalbuminemia(87.3%in all the confirmed and clinical -diagnosed patients),neutropenia(52.4%) and chemotherapy or radiotherapy(50.8%).The treatment effectiveness in the surgical,chemotherapeutic and end-stage patients were 100.0%(108/108),91.6%(87/95) and 52. 9%(9/17),respectively(P<0.001). Conclusion:The IFIs in the patients from the Department of Obstetrics and Gynecology had more severe cases, diverse risk factors,and special distribution of infection sites.The curative effect was excellent for those receiving surgery or chemotherapy.