Chapter: Asymptomatic Bacteriuria
McMaster Section Editor(s): Mark Loeb
Section Editor(s) in Interna Szczeklika: Franciszek Kokot, Robert Drabczyk
McMaster Author(s): Dominik Mertz
Author(s) in Interna Szczeklika: Jan Duława, Robert Drabczyk
Additional Information
How to Cite This Chapter: Mertz D, Duława J, Drabczyk R. Asymptomatic Bacteriuria. McMaster Textbook of Internal Medicine. Kraków: Medycyna Praktyczna. https://empendium.com/mcmtextbook/chapter/B31.II.14.8.5 Accessed June 20, 2019.
Last Updated: March 11, 2015
Last Reviewed: October 4, 2018
Main Documents Taken Into Account: Guidelines on Urological Infections. European Association of Urology. Available at
http://uroweb.org/wp-content/uploads/19-Urological-infections_LR2.pdf. Accessed 24 March 2015.
Gupta K, Hooton TM, Naber KG, et al; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases.
International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011 Mar 1;52(5):e103-20. doi: 10.1093/cid/ciq257. Review. PubMed PMID: 21292654.
Hooton TM, Bradley SF, Cardenas DD, et al; Infectious Diseases Society of America.
Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010 Mar 1;50(5):625-63. PubMed PMID: 20175247.
Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM; Infectious Diseases Society of America; American Society of Nephrology; American Geriatric Society.
Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005 Mar 1;40(5):643-54. Epub 2005 Feb 4. Erratum in: Clin Infect Dis. 2005 May 15;40(10):1556. PubMed PMID: 15714408.
DiagnosisTop
Asymptomatic bacteriuria (ABU) is diagnosed when significant bacteriuria is detected in properly collected urine samples and is not accompanied by clinical signs or symptoms of urinary tract infection. Except for certain cases, ABU must not be treated with antibiotics, as the potential harm outweighs the potential benefits.Strong recommendation (downsides clearly outweigh benefits; right action for all or almost all patients). High Quality of Evidence (high confidence that we know true effects of the intervention). Cai T, Mazzoli S, Mondaini N, Meacci F, Nesi G, D'Elia C, Malossini G, Boddi V, Bartoletti R. The role of asymptomatic bacteriuria in young women with recurrent urinary tract infections: to treat or not to treat? Clin Infect Dis. 2012 Sep;55(6):771-7. doi: 10.1093/cid/cis534. Epub 2012 Jun 7. PubMed PMID: 22677710.
TreatmentTop
ABU requires no treatment, except for:
1) Pregnant patients (see Urinary Tract Infections in Pregnant Women).
2) Patients scheduled for urologic procedures when bleeding is anticipated, including transurethral resection of the prostate. In such individuals start antibacterial prophylaxis on the evening prior to the procedure using an antibiotic selected on the basis of culture results (preferably a fluoroquinolone) and continue only in case of delayed catheter removal.
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