The international sepsis forum consensus conference on definitions of infection in the intensive care unit.
OBJECTIVE
To develop definitions of infection that can be used in clinical trials in patients with sepsis.


BACKGROUND
Infection is a key component of the definition of sepsis, yet there is currently no agreement on the definitions that should be used to identify specific infections in patients with sepsis. Agreeing on a set of valid definitions that can be easily implemented as part of a clinical trial protocol would facilitate patient selection, help classify patients into prospectively defined infection categories, and therefore greatly reduce variability between treatment groups.


METHODS
Experts in infectious diseases, clinical microbiology, and critical care medicine were recruited and allocated specific infection sites. They carried out a systematic literature review and used this, and their own experience, to prepare a draft definition. At a subsequent consensus conference, rapporteurs presented the draft definitions, and these were then refined and improved during discussion. Modifications were circulated electronically and subsequently agreed upon as part of an iterative process until consensus was reached.


RESULTS
Consensus definitions of infection were developed for the six most frequent causes of infections in septic patients: pneumonia, bloodstream infections (including infective endocarditis), intravascular catheter-related sepsis, intra-abdominal infections, urosepsis, and surgical wound infections.


CONCLUSIONS
We have described standardized definitions of the common sites of infection associated with sepsis in critically ill patients. Use of these definitions in clinical trials should help improve the quality of clinical research in this field.
Calandra
Thierry
T
Infectious Diseases Service, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Cohen
Jonathan
J
D002986:Clinical Trials as Topic; D003428:Cross Infection / Q000145:classification / Q000175:diagnosis; D006801:Humans; D007362:Intensive Care Units; D018579:Patient Selection; D018805:Sepsis / Q000145:classification* / Q000175:diagnosis* / Q000209:etiology; D012772:Shock, Septic / Q000145:classification / Q000175:diagnosis; D018746:Systemic Inflammatory Response Syndrome / Q000145:classification / Q000175:diagnosis; D009626:Terminology as Topic