Asymptomatic bacteriuria: Difference between revisions
Gerald Chi (talk | contribs) mNo edit summary |
Gerald Chi (talk | contribs) mNo edit summary |
||
Line 6: | Line 6: | ||
Asymptomatic bacteriuria is a condition in which a significant number of bacteria appear in the urine occurring without typical symptoms such as [[burning during urination]] or [[polyuria|frequent urination]].<ref>http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001548/</ref> | Asymptomatic bacteriuria is a condition in which a significant number of bacteria appear in the urine occurring without typical symptoms such as [[burning during urination]] or [[polyuria|frequent urination]].<ref>http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001548/</ref> | ||
==Diagnostic Criteria== | ==Epidemiology== | ||
==Diagnosis== | |||
===Laboratory Findings=== | |||
====Diagnostic Criteria==== | |||
The diagnosis of bacteriuria in an asymptomatic individual is based on the culture results of urine collected in a manner that minimizes the possibility of contamination and limits the period between sampling and testing the specimen which avoids false positivity due to bacterial growth). | The diagnosis of bacteriuria in an asymptomatic individual is based on the culture results of urine collected in a manner that minimizes the possibility of contamination and limits the period between sampling and testing the specimen which avoids false positivity due to bacterial growth). | ||
Line 18: | Line 25: | ||
==Presumptive Etiologies== | ==Presumptive Etiologies== | ||
===Most common organism=== | ===Most common organism=== | ||
[[Escherichia coli]] is the single most common cause of asymptomatic bacteriuria.<ref name="pmid368263">{{cite journal| author=Evans DA, Williams DN, Laughlin LW, Miao L, Warren JW, Hennekens CH et al.| title=Bacteriuria in a population-based cohort of women. | journal=J Infect Dis | year= 1978 | volume= 138 | issue= 6 | pages= 768-73 | pmid=368263 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=368263 }} </ref> <ref name="pmid4866351">{{cite journal| author=Kunin CM, McCormack RC| title=An epidemiologic study of bacteriuria and blood pressure among nuns and working women. | journal=N Engl J Med | year= 1968 | volume= 278 | issue= 12 | pages= 635-42 | pmid=4866351 | doi=10.1056/NEJM196803212781201 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4866351 }} </ref> <ref name="pmid9764457">{{cite journal| author=Bengtsson C, Bengtsson U, Björkelund C, Lincoln K, Sigurdsson JA| title=Bacteriuria in a population sample of women: 24-year follow-up study. Results from the prospective population-based study of women in Gothenburg, Sweden. | journal=Scand J Urol Nephrol | year= 1998 | volume= 32 | issue= 4 | pages= 284-9 | pmid=9764457 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9764457 }} </ref> <br> | [[Escherichia coli]] is the single most common cause of asymptomatic bacteriuria.<ref name="pmid368263">{{cite journal| author=Evans DA, Williams DN, Laughlin LW, Miao L, Warren JW, Hennekens CH et al.| title=Bacteriuria in a population-based cohort of women. | journal=J Infect Dis | year= 1978 | volume= 138 | issue= 6 | pages= 768-73 | pmid=368263 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=368263 }} </ref> <ref name="pmid4866351">{{cite journal| author=Kunin CM, McCormack RC| title=An epidemiologic study of bacteriuria and blood pressure among nuns and working women. | journal=N Engl J Med | year= 1968 | volume= 278 | issue= 12 | pages= 635-42 | pmid=4866351 | doi=10.1056/NEJM196803212781201 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4866351 }} </ref> <ref name="pmid9764457">{{cite journal| author=Bengtsson C, Bengtsson U, Björkelund C, Lincoln K, Sigurdsson JA| title=Bacteriuria in a population sample of women: 24-year follow-up study. Results from the prospective population-based study of women in Gothenburg, Sweden. | journal=Scand J Urol Nephrol | year= 1998 | volume= 32 | issue= 4 | pages= 284-9 | pmid=9764457 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9764457 }} </ref> <br> | ||
Line 34: | Line 42: | ||
*[[Gardnerella vaginalis]].<ref name="pmid6695949">{{cite journal| author=Lipsky BA, Inui TS, Plorde JJ, Berger RE| title=Is the clean-catch midstream void procedure necessary for obtaining urine culture specimens from men? | journal=Am J Med | year= 1984 | volume= 76 | issue= 2 | pages= 257-62 | pmid=6695949 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6695949 }} </ref> <ref name="pmid2246458">{{cite journal| author=Mims AD, Norman DC, Yamamura RH, Yoshikawa TT| title=Clinically inapparent (asymptomatic) bacteriuria in ambulatory elderly men: epidemiological, clinical, and microbiological findings. | journal=J Am Geriatr Soc | year= 1990 | volume= 38 | issue= 11 | pages= 1209-14 | pmid=2246458 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2246458 }} </ref> | *[[Gardnerella vaginalis]].<ref name="pmid6695949">{{cite journal| author=Lipsky BA, Inui TS, Plorde JJ, Berger RE| title=Is the clean-catch midstream void procedure necessary for obtaining urine culture specimens from men? | journal=Am J Med | year= 1984 | volume= 76 | issue= 2 | pages= 257-62 | pmid=6695949 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6695949 }} </ref> <ref name="pmid2246458">{{cite journal| author=Mims AD, Norman DC, Yamamura RH, Yoshikawa TT| title=Clinically inapparent (asymptomatic) bacteriuria in ambulatory elderly men: epidemiological, clinical, and microbiological findings. | journal=J Am Geriatr Soc | year= 1990 | volume= 38 | issue= 11 | pages= 1209-14 | pmid=2246458 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2246458 }} </ref> | ||
== | ==Treatment== | ||
====Premenopausal, Nonpregnant Women==== | ====Premenopausal, Nonpregnant Women==== |
Revision as of 15:16, 15 January 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdurahman Khalil, M.D. [2]
Overview
Asymptomatic bacteriuria is a condition in which a significant number of bacteria appear in the urine occurring without typical symptoms such as burning during urination or frequent urination.[1]
Epidemiology
Diagnosis
Laboratory Findings
Diagnostic Criteria
The diagnosis of bacteriuria in an asymptomatic individual is based on the culture results of urine collected in a manner that minimizes the possibility of contamination and limits the period between sampling and testing the specimen which avoids false positivity due to bacterial growth).
The quantitative definition of significant bacteriuria is:[2]
- For asymptomatic women, bacteriuria is defined as 2 consecutive voided urine specimens with isolation of the same bacterial strain in quantitative counts of ≥105 cfu/mL.
- A single, clean-catch, voided urine specimen with 1 bacterial species isolated in a quantitative count of ≥105 cfu/mL identifies bacteriuria in asymptomatic men.
- A single catheterized urine specimen with 1 bacterial species isolated in a quantitative count of ≥102 cfu/mL identifies bacteriuria in women or men.
Presumptive Etiologies
Most common organism
Escherichia coli is the single most common cause of asymptomatic bacteriuria.[3] [4] [5]
Patients with abnormal genitourinary tract or institutionalized elderly:
E.Coli remain common cause, but in men Proteus mirabilis is more common.[6]
Long term urologic device in place
Polymicrobial including Pseudomonas aeruginosa,P. mirabilis, Providencia stuartii, and Morganella morganii (urease-producing organisms).[6] [7]
Other organisms
- Coagulase-negative staphylococci especially in men .
- Enterococcus species.
- Group B streptococci
Treatment
Premenopausal, Nonpregnant Women
No screening or treatment recommended for healthy, bacteriuric women.
Although asymptomatic bacteriuria increases the risk of urinary tract infection but has no effect on the long term adverse outcomes like CKD, genitourinary cancer or overall survival.[10] [5]
Studies' results indicated that the treatment wouldn't decrease the frequency for asymptomatic bacteriuria or the risk of developing symptomatic urinary tract infection.[11]
Pregnant Women
Diabetic WomenAsymptomatic bacteriuria screening or treatment is not recommended for diabetic women.
Older Persons Residing in the CommunityRoutine screening and treatment for asymptomatic bacteriuria is not indicated.
Elderly Institutionalized SubjectsNo recommendation for screening for or treatment of asymptomatic bacteriuria.
Subjects with Spinal Cord InjuriesNo benefit from screening for or treatment of asymptomatic bacteriuria Although the high prevalence of asymptomatic bacteriuria in patients with spinal cord injuries[26], but antimicrobial therapy harm outweigh benefit because of recurrent infections with more resistant strains.[27] Patients with Indwelling Urethral CathetersIt is not recommended to screen for or treat asymptomatic bacteriuria or fungiuria for short or long term catheters,[28] but antimicrobial therapy can be used for women with persistent bacteriuria 48 hours after removal of the urethral catheter.
Urologic Interventions
|