Asymptomatic Bacteriuria Management

Publication Date: May 15, 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

...nagement...

...al Populations...

...infants and children, the IDSA reco...

...ealthy pre-menopausal, non-pregnant...

...en, the IDSA recommends screening for and treati...

...regnant women with ASB, the IDSA suggests 4–7...

...community-dwelling persons who are funct...

...er persons resident in long-term care faci...


...omorbidit...

...der patients with functional or cognitiv...

...ients with functional and/or cognitive impairment...

...h diabetes, the IDSA recommends against scree...

...l transplant recipients who have ha...

...ents with non-renal solid organ transplants, the...

...n patients with high-risk neutrope...

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


...heters...

...atients with a short-term indwelling urethral...

...s with indwelling catheters, the IDSA ma...

...long-term indwelling catheters, the I...


...urger...

...ents undergoing elective non-urologic surgery the...

...ts who will undergo endoscopic urologic proced...

In patients who will undergo endoscopic urologic...

...s with ASB who will undergo a urologic...

...anning to undergo surgery for an artific...


Device...

...iving with implanted urologic devices, the IDSA...