TABLE 1.

Unit clinical criteria for establishing a diagnosis of proven, possible, or probable invasive candidiasis

Type of candidiasis	Criteria
I.Proven invasive candidiasis	Candidemia with temporally related clinical signs and symptoms compatible with the relevant organism Candida spp. from sterile site other than (i) urine or (ii) peritoneal fluid in a setting of gastrointestinal perforation
II.Probable invasive candidiasis	Candidemia without the clinical findings of criteria I.1 Candida spp. from ≥2 nonsterile sites in association with all of the following within the preceding or subsequent 3 days (day of positive cultures ± 3 days). If the nonsterile site cultures are obtained on different days, then the time window for the listed supporting factors extends from 3 days before the first positive culture for Candida spp. to 3 days after the last positive culture for Candida spp.: Temperature ≥ 38.5°C (101.3°F) on at least on occasion WBCc ≥ 12,000/mm3 on at least one occasion No bacterial pathogens at any possibly infected site, with the exception of coagulase-negative staphylococci in the blood or on a catheter tip Candida spp. from urine at ≥100,000 CFU/ml plus other criteria as in II.2 Candida spp. from a central venous catheter tip at ≥15 CFU in association with all of the following within the preceding or subsequent 3 days (day of positive culture ± 3 days): Temp ≥ 38.5°C (101.3°F) OR WBC ≥ 12,000/mm3 No bacterial pathogens at any possibly infected site, with the exception of coagulase-negative staphylococci in the blood or on a catheter tip Empirical treatment with systemic antifungal agents initiated due to a persistent temp of ≥38.5°C (101.3°F) OR WBC ≥ 12,000/mm3 despite ≥3 days of broad-spectrum antibiotics in association with one of the following clinical scenarios:
	Scenario A—the patient shows both of the following: Candida spp. from at least one nonsterile site OR at least one central venous catheter tip at <15 CFU No bacterial pathogens at any possibly infected site within the preceding or subsequent 3 days (day of initiation of therapy ± 3 days) with the exception of coagulase-negative staphylococci in the blood or on a catheter tip
	Scenario Ba—the patient has Candida spp. at ≥2 of the following: Any nonsterile site A central venous catheter tip at <15 CFU
III.Possible invasive candidiasis	Candida from a central venous catheter tip at ≥15 CFU not satisfying criteria as in II.4b Empirical treatment as in II.5, but without data satisfying either clinical scenario

^aNote that this scenario does not exclude concomitant bacterial infections at other sites. This is the weakest of the probable forms.

^bNote that growth of <15 CFU from a catheter tip without findings as in II.5 does not even meet the definition of possible and is not coded as a candidal infection at all.

^cWBC, white blood cell count.