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Bacteriuria, Asymptomatic

Mony Fraer, MD, FACP, FASN and Kantima Phisitkul, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

Asymptomatic bacteriuria (ASB) is diagnosed when significant bacteriuria is not accompanied by signs and symptoms attributable to urinary tract infection (UTI). 

EPIDEMIOLOGY

Incidence

  • ...

DIAGNOSIS

HISTORY

  • Asymptomatic

  • Lack of symptoms attributable to UTI such as fever, acute dysuria (<1 week), new or worsening urinary urgency/frequency/incontinence, or acute gross hematuria

PHYSICAL EXAM

TREATMENT

GENERAL MEASURES

ALERT

  • Antibiotic treatment of ASB is indicated in only two conditions:

    • Pregnancy (1)[A]

      • Rationale: Treatment has been shown to significantly reduce the incidence of acute py...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

No consensus on screening frequency of ASB in pregnancy, but monthly screening of urine culture after ASB treatment is recommended except GBS (1,2). 

Patient Monitoring

REFERENCES

1 Nicolle LE, Bradley S, Colgan R, et al. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis.  20...

ADDITIONAL READING

  • Köves B, Cai T, Veeratterapillay R, et al. Benefits and harms of treatment of asymptomatic bacteriuria: a systematic review and meta-analysis by the European Association of Urology ...

CODES

ICD10

  • N39.0 Urinary tract infection, site not specified

  • B96.20 Unsp Escherichia coli as the cause of diseases classd elswhr

  • B96.1 Klebsiella pneumoniae as the cause of diseases classd elswhr

ICD9

  • 791...

CLINICAL PEARLS

  • ASB is a common and benign disorder for which treatment is not indicated in most patients.

  • The presence of pyuria, leukocyte esterase, and nitrite is common in ASB and not an indication...

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