Criteria for deep Candida sternal wound infection - all of the following:
(1) isolation of Candida species from purulent drainage or tissue
(2) clinical inflammation (2 or more of the following: erythema, warmth, swelling, purulent drainage, tenderness, pain)
(3) absence of other micro-organisms to explain the findings, OR failure of infection to respond to therapy directed against other organisms (bacteria)
(4) clinical response after appropriate antifungal therapy
Conditions to exclude:
(1) superficial wound colonization
(2) superficial wound infection
(3) suture abscesses
(4) infection around a chest tube
Criteria for Candidal mediastinitis:
(1) evidence of mediastinal involvement (at surgery, on imaging studies)
(2) isolation of Candida species from mediastinal tissues
Criteria for Candidal osteomyelitis:
(1) evidence of bone infection (CT scan, at surgery, on removal of sternal wires)
(2) isolation of Candida species from affected bone
Criteria for definite deep Candida infection:
(1) meet criteria for Candidal mediastinitis or osteomyelitis
(2) repeat cultures are positive for Candida species
If the patient only meets the first criteria, then the patient is classified as probable deep Candida infection.
