Asymptomatic Bacteriuria Management

Publication Date: March 19, 2019

Key Points

Key Points

The definition of ASB5 in patients without indwelling catheters is ≥10 cfu/mL (≥10 cfu/L) in a voided urine specimen without signs or symptoms attributable to 8UTI.
  • For women, two consecutive specimens should be obtained, preferably within 2 weeks, to confirm the persistence of bacteriuria. From 10–60% of women, varying with the population, do not have persistent bacteriuria on repeat screening after an initial positive specimen.
  • For men, a single urine specimen meeting these quantitative criteria is sufficient for diagnosis.
Observational and intervention studies evaluating long-term screening and treatment in school children and healthy women suggest that ASB is benign in children and in women who were not pregnant. In addition, efforts to maintain sterile urine are often futile.

Screening for and treatment of ASB is only recommended for pregnant women and prior to endourologic procedures.

Studies in other populations suggest that antimicrobial treatment does not confer any benefits, but does increase the risk of adverse outcomes including antimicrobial resistance and Clostridiodes difficile infection. In some cases the risk of UTI shortly following therapy may be increased.

Management

...anagement

...ial Populatio...

In infants and children, the IDSA recommends aga...

...thy pre-menopausal, non-pregnant women or...

...n, the IDSA recommends screening for and...

...pregnant women with ASB, the IDSA suggests...

...n older, community-dwelling persons who...

...der persons resident in long-term c...


Comorbiditie...

...tients with functional or cognitive impai...

...patients with functional and/or cognitive im...

...diabetes, the IDSA recommends again...

...al transplant recipients who have had re...

...with non-renal solid organ transplant...

...patients with high-risk neutropenia (...

...with spinal cord injury (SCI), the ID...


...athete...

...s with a short-term indwelling urethral catheter (...

...s with indwelling catheters, the I...

...h long-term indwelling catheters, the IDS...


...rgery...

...undergoing elective non-urologic surge...

...who will undergo endoscopic urologic...

...patients who will undergo endoscopic urolo...

...patients with ASB who will undergo...

...lanning to undergo surgery for an artificial u...


Devices

...ents living with implanted urologic devices, t...