We appreciate the response by Dr Hospenthal and offer the following commentary.
It is important to emphasize that the objectives of our study were to document the incidence and progression of risk factors across time and to assess the relationship between risk factor progression and Candida colonization or infection in the surgical intensive care unit (SICU). The conclusions of our study are drawn from the progression and change in risk factors in the patients with colonization and infection (combined), as shown in Table 3 of our original article, and are not subject to influence by our definition of disseminated infection (DI). In fact, none of our conclusions were based on a distinction between the locally colonized and DI groups. The mortality differences cited by Dr Hospenthal may have occurred because we reported only the SICU mortality rate rather than total mortality. Patients did not receive follow-up after discharge from the SICU because this outcome was not pertinent to the objectives of our study.
McKinnon PS. Disseminated Infection?—Reply. Arch Surg. 2002;137(7):867. doi: