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Reduced Intravascular Infection by Antibiotic Bonding-Reply

Gagan D. Kamal, FFARCS; Michael A. Pfaller, MD; Lynn E. Rempe, RN; Peter J. R. Jebson, FFARCS
JAMA. 1991;266(11):1514. doi:10.1001/jama.1991.03470110060033.
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In Reply.  —Dr Baltimore brings up an issue that needs to be addressed, namely, standardized definitions for catheterrelated infectious complications. Since there is currently no consensus in the literature,1 investigators are obligated to state clearly the scope and meaning of definitions used by them, as we have done. Whether it is the patient, organ(s) of a patient, or prosthetic devices that get infected is an interesting point of semantics. Our reference to "infected catheter" was in the same vein as a surgeon who takes a patient to the operating room to remove an "infected graft." Baltimore rightly points out that by our definition there was no catheter-related bloodstream infection in our study. As suggested by Maki et al,2 15 or more colonies represent the precursor of catheter-related septicemia. As such, we believe that a mean colony count of 252 colony-forming units per catheter has obvious significance.Dr Solomon


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