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March 11, 1988

Dressing Regimens and Intravenous Catheter—Related Infections-Reply

JAMA. 1988;259(10):1498-1499. doi:10.1001/jama.1988.03720100020024

In Reply.  —With regard to Dr Johnson's first comment, the semiquantitative technique for culturing intravascular catheters, and, specifically, the use of greater than 15 CFUs as denoting infection, has been reaffirmed in studies in a number of other centers besides our own as being of value for distinguishing infected catheters from contamination during sampling.1-3 The fact that a positive semiquantitative culture is not associated with local signs of infection or bacteremia does not detract from the usefulness of the technique. A positive semiquantitative culture without local or systemic signs of infection may represent "colonization." But the situation is similar to asymptomatic bacteriuria, in which greater than 105 CFUs/mL of clean voided urine is widely considered to represent infection4; the fact that a patient with a urine culture showing greater than 105 CFUs/mL does not have pyuria, bacteremia, or signs of infection does not detract from the