Table 1.
A. Algorithm for invasive infections | |
1 | Does the patient have a significant positive isolate from bacterial blood cultures with a disease‐causing pathogen (excluding positive blood cultures disappearing after removal of IV catheters/devices)? |
2 | Does the patient have clinical signs and symptoms compatible with an invasive tissue bacterial infection > 5 cm in diameter? |
3 | Does the patient have an (suspicion for) invasive fungal disease? |
4 | Does the patient have a strong clinical suspicion for invasive tissue infection despite not clearly fulfilling Criteria 1‐3 above? |
If 1 and/or 2 is yes: bacterial invasive infection record was scored. If 3 is yes: fungal invasive infection record was scored. If 4 is yes: both bacterial and fungal invasive infection records were scored. | |
B. Criteria for GTX* | |
1. Granulocytes < 0.5 × 109/L ≥ 72 hr | |
2. Life‐threatening infection† | |
3. Infection is not responding to systemic antimicrobial therapy ≥48 hr | |
4. Fever (>38.0°C) | |
5. Life expectancy of more than three months (in absence of infection) | |
6. Expecting to recover from the granulocytopenia |
When fulfilling all Criteria 1, 2, and 3, patients are regarded as eligible for GTX.
An infection was regarded as life‐threatening when there was a clinical deterioration of a patient requiring supportive measurements, like admittance to an intensive care unit, extensive oxygen support (>5 L O2/min), fluid resuscitation in case of severe sepsis (severe sepsis defined as sepsis plus sepsis‐induced organ dysfunction or tissue hypoperfusion), or severe organ dysfunction as a result of the infection.