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Bacteriuria: Colonization or Infection

Philip J. Kozinn, MD; Philip K. Goldberg; S. Raymond Gambino, MD
JAMA. 1985;253(13):1878-1879. doi:10.1001/jama.1985.03350370058017.
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To the Editor.—  The term urinary tract infection (UTI) in the title of the article by Daifuku and Stamm1 is misleading in that their investigation only proves an increase, in urine specimens, of organisms that were previously present in the urethra or rectum. It presents no clinical, cystoscopic, or histologie evidence of UTI. This increase in organisms in asymptomatic patients may be a reaction to a foreign body without invasion of tissues. In contrast, we correlated colony counts with histologie findings (62 autopsies and two biopsies) in patients with evidence suggesting the possibility of renal candidosis.2 The mean Candida colony count in 11 patients with an indwelling Foley catheter and histologically proved urinary tract candidosis was 64,000 ±32,000/mL. Five cases with an indwelling Foley catheter and the absence of urinary tract candidosis (histologically proved) was 72,000 ±28,000/mL. One patient had more than 200,000 Candida organisms per milliliter without


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