Bacteriuria, Asymptomatic

Johnny J Yang, MD, MS and Bindusri Paruchuri, MD Reviewed 05/2023

BASICS

DESCRIPTION

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

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
  - Rationale: Treatment prevents up to 70% of pregnant women from developing acute pyelonephritis, ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

No consensus on rescreening frequency of ASB in pregnancy. Per American College of Gynecology (ACOG) guidelines, follow-up urine culture, after treatment, is reco...

REFERENCES

US Preventive Services Task Force. Screening for Asymptomatic Bacteriuria in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2019;322(12):1188–1194. doi:10.1001/j...

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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