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

Intensive Care Med. 2024 Apr;50(4):502-515. doi: 10.1007/s00134-024-07341-7. Epub 2024 Mar 21.

Abstract

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.

Keywords: Aspergillus; Candida; Consensus; Definitions; Diagnosis; Intensive care unit; Invasive fungal diseases; Research.

MeSH terms

  • Adult
  • Aspergillosis* / diagnosis
  • Candidiasis, Invasive* / diagnosis
  • Consensus
  • Humans
  • Intensive Care Units
  • Invasive Fungal Infections* / diagnosis