Patient selection: surgical patient in the ICU with signs and symptoms of infection
Criteria for a definite fungal infection:
(1) histologic evidence of invasive fungal infection in a biopsy, autopsy, surgical specimen, etc
(2) microbiologic evidence with >= 2 separate cultures from normally sterile sites (closed body cavity, organ, etc), excluding urine and sputum
Criteria for a presumed or probable fungal infection - one or more of the following:
(1) positive blood culture for fungi (yeast) by venipuncture
(2) positive fungal culture from a 1 normally sterile site (closed body cavity or organ), excluding indwelling peritoneal drain and biliary catheters
(3) intravascular catheter tip culture positive for > 15 colonies of yeast
(4) deep surgical site infection (SSI) with positive fungal culture and requiring debridement
(5) urine culture positive for fungi AND specimen collected by straight catheterization
(6) urine culture positive for fungi both before and after a change in an indwelling urinary catheter
Criteria for a suspected fungal infection - all of the following:
(1) clinician initiates antifungal therapy for suspected infection (not prophylaxis)
(2) signs of end-organ dysfunction
(3) evidence of fungal colonization (such as positive culture of sputum, urine, peritoneal drain or biliary catheter)
