Resolution of Chronic Hepatitis B after Ritonavir Treatment in an HIV-Infected Patient

To the Editor: Dr. Darouiche and colleagues (Jan. 7 issue) 1 conclude that the use of central venous catheters impregnated with minocycline and rifampin is associated with a lower rate of catheter-related bloodstream infection than the use of catheters impregnated with chlorhexidine and silver sulfadiazine. They defined a catheter-related bloodstream infection by the isolation of the same organism from the vascular catheter and from peripheral blood in a patient with sepsis and no other apparent source of bloodstream infection. However, residual antimicrobial activity in the removed catheter sufficient to prevent growth from the cultured catheter segments would substantially reduce the apparent rate of catheter-related bloodstream infections (since a catheter-related bloodstream infection cannot occur on the basis of this definition if no growth is recorded from the cultured catheter segments).