Asymptomatic Bacteriuria

Clinic A/P, adults, Clinic A/P, Peds, Hospital A/P, Adults, Hospital A/P, Peds

Bacteriuria without symptoms
Midstream: ≥105 CFU/ml
Cath: ≥102CFU/ml
Pyuria is present > 50% of patients

 

Asymptomatic bacteria in patients with a transplanted kidney? No benefit to treating.

Acute AMS in an elderly patient in a nursing home. UA and Cx shows bacteriuria. What should you do? R/o other causes of AMS and have UTI be a diagnosis of exclusion. Asx bacteriuria is very common in elderly nursing home patients. So you can’t rush to attribute the AMS to UTI. But if you r/o everything else, then you can then call it UTI if nothing else is found.

Two groups of people to screen with urine culture and treat asymptomatic bacteriuria.

  • Pregnant women. Get a urine culture at 12–16 weeks gestation or at the first prenatal visit if it occurs later.
  • Patients undergoing prostate surgery or other invasive urologic surgery. Before transurethral resection of the prostate (TURP) and also before other urologic procedures for which mucosal bleeding is anticipated.

In addition to that, asymptomatic bacteriuria should also be treated in

  • Kidney or pancreas organ transplant patients within the first year of receiving the transplant.

 

Reference

USPSTF guidelines
IDSA Guidelines

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