Invasive Fungal Diseases in Adult Patients in Intensive Care Unit (FUNDICU): 2024 consensus definitions from ESGCIP, EFISG, ESICM, ECMM, MSGERC, ISAC, and ISHAM

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2024年3月21日

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Matteo Bassetti,
Daniele R. Giacobbe,
Christina Agvald-Ohman,
Murat Akova,
Ana Alastruey-Izquierdo,
Sevtap Arikan-Akdagli,
Elie Azoulay,
Stijn Blot,
Oliver A. Cornely,
Manuel Cuenca-Estrella,
Dylan W. de Lange,
Francesco G. De Rosa,
Jan J. De Waele,
George Dimopoulos,
Jose Garnacho-Montero,
Martin Hoenigl,
Souha S. Kanj,
Philipp Koehler,
Bart J. Kullberg,
Frédéric Lamoth,
Cornelia Lass-Flörl,
Johan Maertens,
Ignacio Martin-Loeches,
Patricia Muñoz,
Garyphallia Poulakou,
Jordi Rello,
Maurizio Sanguinetti,
Fabio S. Taccone,
Jean-François Timsit,
Antoni Torres,
Jose A. Vazquez,
Joost Wauters,
Erika Asperges,
Andrea Cortegiani,
Cecilia Grecchi,
Ilias Karaiskos,
Clément Le Bihan,
Toine Mercier,
Klaus L. Mortensen,
Maddalena Peghin,
Chiara Rebuffi,
Sofia Tejada,
Antonio Vena,
Valentina Zuccaro,
Luigia Scudeller,
Thierry Calandra,
Claire Roger,
Christian Eckmann,
Jean-Pierre Gangneux,
Esther Segal,
Geoffrey Coombs,
Andreas Voss

摘要

Purpose

The aim of this document was to develop standardized research definitions of invasive fungal diseases (IFD) in non-neutropenic, adult patients without classical host factors for IFD, admitted to intensive care units (ICUs).

Methods

After a systematic assessment of the diagnostic performance for IFD in the target population of already existing definitions and laboratory tests, consensus definitions were developed by a panel of experts using the RAND/UCLA appropriateness method.

Results

Standardized research definitions were developed for proven invasive candidiasis, probable deep-seated candidiasis, proven invasive aspergillosis, probable invasive pulmonary aspergillosis, and probable tracheobronchial aspergillosis. The limited evidence on the performance of existing definitions and laboratory tests for the diagnosis of IFD other than candidiasis and aspergillosis precluded the development of dedicated definitions, at least pending further data. The standardized definitions provided in the present document are aimed to speed-up the design, and increase the feasibility, of future comparative research studies.