What colony count threshold does the speaker say labs use to call a pocket infected?

Robert Whitfield MDAmerica's Breast Implant Illness Expert™

Understanding Breast Implant Care: Managing Infections and Solutions

1 Apr 2025 · 1 min

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1:20

A clinician-to-clinician/video interview excerpt with Robert Whitfield MD discussing breast implant pocket management, differences in treating suspected infections after explant/capsulectomy, and the limitations of standard culture-based infection detection. The speaker contrasts using low-pH irrigating solutions versus relying solely on antibiotics/antifungals and notes that standard lab culture definitions typically require >100,000 colony-forming units to call a pocket "infected."

Questions this video answers

Greater than 100,000 colony-forming units (CFU) on culture.

Chapters

So explain that difference because some people may have gotten already their breast explants and were told they were negative for infection and never treated. Do you then need to go back and do anything different?
Yeah, I mean, that's a great question. I haven't, I've had people come with incomplete capsule resections and I've taken care of them. It just became really. It was obvious that what we were doing, whether it was placement or removals or explants, something needed to be changed in terms of how you manage the pocket. So a lot of people are worried about not just placement of implants, but somebody who gets a capsular contractor. So a lot of research was done using solutions that lower the pH. And in particular, if you think about it, that makes much more sense because then it's not dependent upon bacitracin, which is an antibiotic, or clindamycin, which is antibiotic, or anything any antifungal put in there. So in a CLIA based system, you swab the pocket using the Q tip and you rub it on a plate once it gets to the lab. And then it has to grow above a hundred thousand colony units for them to. Then the lab tech to go, oh yeah, this is infection.