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Bacteriuria, Asymptomatic

Onameyore Utuama, MPH, MD and Kitty Brigitta Carter-Wicker, MD Reviewed 06/2021
 


BASICS

DESCRIPTION

Asymptomatic bacteriuria (ASB) is specific bacterial growth ≥105 CFU/mL in one and two consecutive midstream urine samples for men and women, respectively >18 years. This definiti...

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 prevents up to 70% of pregnant women from developing acute pyelonep...

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). 

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. ...

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 Eu...

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

SNOMED

  • 2...

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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