Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group.
BACKGROUND
Invasive fungal diseases are important causes of morbidity and mortality. Clarity and uniformity in defining these infections are important factors in improving the quality of clinical studies. A standard set of definitions strengthens the consistency and reproducibility of such studies.


METHODS
After the introduction of the original European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group definitions, advances in diagnostic technology and the recognition of areas in need of improvement led to a revision of this document. The revision process started with a meeting of participants in 2003, to decide on the process and to draft the proposal. This was followed by several rounds of consultation until a final draft was approved in 2005. This was made available for 6 months to allow public comment, and then the manuscript was prepared and approved.


RESULTS
The revised definitions retain the original classifications of "proven," "probable," and "possible" invasive fungal disease, but the definition of "probable" has been expanded, whereas the scope of the category "possible" has been diminished. The category of proven invasive fungal disease can apply to any patient, regardless of whether the patient is immunocompromised, whereas the probable and possible categories are proposed for immunocompromised patients only.


CONCLUSIONS
These revised definitions of invasive fungal disease are intended to advance clinical and epidemiological research and may serve as a useful model for defining other infections in high-risk patients.
De Pauw
Ben
B
Department of Blood Transfusion Service and Transplant Immunology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Walsh
Thomas J
TJ
Donnelly
J Peter
JP
Stevens
David A
DA
Edwards
John E
JE
Calandra
Thierry
T
Pappas
Peter G
PG
Maertens
Johan
J
Lortholary
Olivier
O
Kauffman
Carol A
CA
Denning
David W
DW
Patterson
Thomas F
TF
Maschmeyer
Georg
G
Bille
Jacques
J
Dismukes
William E
WE
Herbrecht
Raoul
R
Hope
William W
WW
Kibbler
Christopher C
CC
Kullberg
Bart Jan
BJ
Marr
Kieren A
KA
Muñoz
Patricia
P
Odds
Frank C
FC
Perfect
John R
JR
Restrepo
Angela
A
Ruhnke
Markus
M
Segal
Brahm H
BH
Sobel
Jack D
JD
Sorrell
Tania C
TC
Viscoli
Claudio
C
Wingard
John R
JR
Zaoutis
Theoklis
T
Bennett
John E
JE
D006801:Humans; D009181:Mycoses / Q000145:classification* / Q000175:diagnosis*; D009626:Terminology as Topic