Asymptomatic bacteriuria: Difference between revisions

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| <figure-inline>[[File:Siren.gif|link=Urinary tract infection resident survival guide|41x41px]]</figure-inline>|| <br> || <br>
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| [[Urinary tract infection resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
| [[Urinary tract infection resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
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=== 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><ref>{{Cite journal
* ''[[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><ref>{{Cite journal
  | author = [[Joseph Ayodeji Olamijulo]], [[Chris Olu Adewale]] & [[Olalekan Olaleye]]
  | author = [[Joseph Ayodeji Olamijulo]], [[Chris Olu Adewale]] & [[Olalekan Olaleye]]
  | title = Asymptomatic bacteriuria among antenatal women in Lagos
  | title = Asymptomatic bacteriuria among antenatal women in Lagos
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  | pmid = 26960990
  | pmid = 26960990
}}</ref>
}}</ref>
 
* Other causes of asymptomatic bacteriuria include:
Other common causes of asymptomatic bacteriuria include:
{| class="wikitable"
{| class="wikitable"
!Common  
!Common Causes
Causes
!Less Common Causes
!Less Common
!GU abnormalities & Hospitalization
Causes
!GU abnormalities  
&
Hospitalization
!Long Term Catheterisation<ref name="pmid9378928">{{cite journal| author=Nicolle LE| title=Asymptomatic bacteriuria in the elderly. | journal=Infect Dis Clin North Am | year= 1997 | volume= 11 | issue= 3 | pages= 647-62 | pmid=9378928 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9378928  }} </ref><ref name="pmid6815281">{{cite journal| author=Warren JW, Tenney JH, Hoopes JM, Muncie HL, Anthony WC| title=A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters. | journal=J Infect Dis | year= 1982 | volume= 146 | issue= 6 | pages= 719-23 | pmid=6815281 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6815281  }} </ref>
!Long Term Catheterisation<ref name="pmid9378928">{{cite journal| author=Nicolle LE| title=Asymptomatic bacteriuria in the elderly. | journal=Infect Dis Clin North Am | year= 1997 | volume= 11 | issue= 3 | pages= 647-62 | pmid=9378928 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9378928  }} </ref><ref name="pmid6815281">{{cite journal| author=Warren JW, Tenney JH, Hoopes JM, Muncie HL, Anthony WC| title=A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters. | journal=J Infect Dis | year= 1982 | volume= 146 | issue= 6 | pages= 719-23 | pmid=6815281 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6815281  }} </ref>
|-
|-
|[[Enterococcus]]<ref>{{Cite journal
|[[Enterococcus|''Enterococcus'']]<ref>{{Cite journal
  | author = [[A.-K. Labi]], [[A. E. Yawson]], [[G. Y. Ganyaglo]] & [[M. J. Newman]]
  | author = [[A.-K. Labi]], [[A. E. Yawson]], [[G. Y. Ganyaglo]] & [[M. J. Newman]]
  | title = Prevalence and Associated Risk Factors of Asymptomatic Bacteriuria in Ante-Natal Clients in a Large Teaching Hospital in Ghana
  | title = Prevalence and Associated Risk Factors of Asymptomatic Bacteriuria in Ante-Natal Clients in a Large Teaching Hospital in Ghana
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  | pmid = 26693190
  | pmid = 26693190
}}</ref>
}}</ref>
|[[Chromobacterium violaceum|Chromobacterium violaceum]]<ref>{{Cite journal
|''[[Chromobacterium violaceum|Chromobacterium violaceum]]<ref>{{Cite journal
  | author = [[Narayan Dutt Pant]], [[Manisha Sharma]] & [[Saroj Khatiwada]]
  | author = [[Narayan Dutt Pant]], [[Manisha Sharma]] & [[Saroj Khatiwada]]
  | title = Asymptomatic Bacteriuria Caused by Chromobacterium violaceum in an Immunocompetent Adult
  | title = Asymptomatic Bacteriuria Caused by Chromobacterium violaceum in an Immunocompetent Adult
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  | doi = 10.1155/2015/652036
  | doi = 10.1155/2015/652036
  | pmid = 26504464
  | pmid = 26504464
}}</ref>
}}</ref>''
| rowspan="2" |[[E.Coli|E.Coli]]<ref name="pmid9378928">{{cite journal| author=Nicolle LE| title=Asymptomatic bacteriuria in the elderly. | journal=Infect Dis Clin North Am | year= 1997 | volume= 11 | issue= 3 | pages= 647-62 | pmid=9378928 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9378928  }} </ref><ref>{{Cite journal
|''[[Escherichia coli|E.coli]]<ref name="pmid9378928">{{cite journal| author=Nicolle LE| title=Asymptomatic bacteriuria in the elderly. | journal=Infect Dis Clin North Am | year= 1997 | volume= 11 | issue= 3 | pages= 647-62 | pmid=9378928 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9378928  }} </ref><ref>{{Cite journal
  | author = [[Joseph Ayodeji Olamijulo]], [[Chris Olu Adewale]] & [[Olalekan Olaleye]]
  | author = [[Joseph Ayodeji Olamijulo]], [[Chris Olu Adewale]] & [[Olalekan Olaleye]]
  | title = Asymptomatic bacteriuria among antenatal women in Lagos
  | title = Asymptomatic bacteriuria among antenatal women in Lagos
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  | doi = 10.3109/01443615.2016.1148675
  | doi = 10.3109/01443615.2016.1148675
  | pmid = 26960990
  | pmid = 26960990
}}</ref>
}}</ref>''
|[[Pseudomonas aeruginosa]]
|[[Pseudomonas aeruginosa|''Pseudomonas aeruginosa'']]
|-
|-
|[[Enterobacteriaceae]]<ref>{{Cite journal
|[[Enterobacteriaceae]]<ref>{{Cite journal
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  | pmid = 26693190
  | pmid = 26693190
}}</ref>
}}</ref>
|[[Staphylococci]]<ref>{{Cite journal
|''[[Staphylococci]]<ref>{{Cite journal
  | author = [[A. P. Roberts]] & [[R. Phillips]]
  | author = [[A. P. Roberts]] & [[R. Phillips]]
  | title = Bacteria causing symptomatic urinary tract infection or asymptomatic bacteriuria
  | title = Bacteria causing symptomatic urinary tract infection or asymptomatic bacteriuria
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  | month = May
  | month = May
  | pmid = 381327
  | pmid = 381327
}}</ref>
}}</ref>''
|[[P. mirabilis]]
|''[[Proteus mirabilis|Proteus mirabilis]]<ref name="pmid9378928" /><ref>{{Cite journal
|-
|[[Klebsiella]]<ref>{{Cite journal
  | author = [[Joseph Ayodeji Olamijulo]], [[Chris Olu Adewale]] & [[Olalekan Olaleye]]
  | author = [[Joseph Ayodeji Olamijulo]], [[Chris Olu Adewale]] & [[Olalekan Olaleye]]
  | title = Asymptomatic bacteriuria among antenatal women in Lagos
  | title = Asymptomatic bacteriuria among antenatal women in Lagos
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  | doi = 10.3109/01443615.2016.1148675
  | doi = 10.3109/01443615.2016.1148675
  | pmid = 26960990
  | pmid = 26960990
}}</ref>
}}</ref>''
|[[Gardnerella vaginalis|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>
|[[P. mirabilis|''P. mirabilis'']]
|[[Proteus mirabilis|Proteus mirabilis]]<ref name="pmid9378928">{{cite journal| author=Nicolle LE| title=Asymptomatic bacteriuria in the elderly. | journal=Infect Dis Clin North Am | year= 1997 | volume= 11 | issue= 3 | pages= 647-62 | pmid=9378928 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9378928  }} </ref><ref>{{Cite journal
|-
|''[[Klebsiella]]<ref>{{Cite journal
  | author = [[Joseph Ayodeji Olamijulo]], [[Chris Olu Adewale]] & [[Olalekan Olaleye]]
  | author = [[Joseph Ayodeji Olamijulo]], [[Chris Olu Adewale]] & [[Olalekan Olaleye]]
  | title = Asymptomatic bacteriuria among antenatal women in Lagos
  | title = Asymptomatic bacteriuria among antenatal women in Lagos
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  | doi = 10.3109/01443615.2016.1148675
  | doi = 10.3109/01443615.2016.1148675
  | pmid = 26960990
  | pmid = 26960990
}}</ref>
}}</ref>''
|[[Providencia stuartii]]
|''[[Gardnerella vaginalis|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>''
|
|[[Providencia stuartii|''Providencia stuartii'']]
|-
|-
|[[Pseudomonas aeruginosa|Pseudomonas aeruginosa]]<ref>{{Cite journal
|''[[Pseudomonas aeruginosa|Pseudomonas aeruginosa]]<ref>{{Cite journal
  | author = [[Richard Colgan]], [[Lindsay E. Nicolle]], [[Andrew McGlone]] & [[Thomas M. Hooton]]
  | author = [[Richard Colgan]], [[Lindsay E. Nicolle]], [[Andrew McGlone]] & [[Thomas M. Hooton]]
  | title = Asymptomatic bacteriuria in adults
  | title = Asymptomatic bacteriuria in adults
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  | month = September
  | month = September
  | pmid = 17002033
  | pmid = 17002033
}}</ref>
}}</ref>''
| rowspan="2" |[[Elizabethkingia meningoseptica|Elizabethkingia meningoseptica]]<ref>{{Cite journal
|''[[Elizabethkingia meningoseptica|Elizabethkingia meningoseptica]]<ref>{{Cite journal
  | author = [[Zhiyong Zong]]
  | author = [[Zhiyong Zong]]
  | title = Elizabethkingia meningoseptica as an unusual pathogen causing healthcare-associated bacteriuria
  | title = Elizabethkingia meningoseptica as an unusual pathogen causing healthcare-associated bacteriuria
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  | month =  
  | month =  
  | pmid = 25130129
  | pmid = 25130129
}}</ref>
}}</ref>''
|
|
|[[Morganella morganii]]  
|[[Morganella morganii|''Morganella morganii'']]  
|-
|-
|[[Group B Streptococcus]]<ref>{{Cite journal
|''[[Group B Streptococcus]]<ref>{{Cite journal
  | author = [[Richard Colgan]], [[Lindsay E. Nicolle]], [[Andrew McGlone]] & [[Thomas M. Hooton]]
  | author = [[Richard Colgan]], [[Lindsay E. Nicolle]], [[Andrew McGlone]] & [[Thomas M. Hooton]]
  | title = Asymptomatic bacteriuria in adults
  | title = Asymptomatic bacteriuria in adults
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  | doi = 10.1155/2015/652036
  | doi = 10.1155/2015/652036
  | pmid = 26504464
  | pmid = 26504464
}}</ref>
}}</ref>''
|
|
|
|
|
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  | pmid = 4866351
  | pmid = 4866351
}}</ref>
}}</ref>
*The [[prevalence]] of [[bacteriuria]] in [[women]] increase with age.<ref>{{Cite journal
*Asymptomatic bacteriuria has a [[prevalence]] of 8-14% in [[diabetic]] [[women]].<ref>{{Cite journal
| author = [[G. G. Zhanel]], [[L. E. Nicolle]] & [[G. K. Harding]]
| title = Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. The Manitoba Diabetic Urinary Infection Study Group
| journal = [[Clinical infectious diseases : an official publication of the Infectious Diseases Society of America]]
| volume = 21
| issue = 2
| pages = 316–322
| year = 1995
| month = August
| pmid = 8562738
}}</ref>
 
===Age===
*Asymptomatic bacteriuria is more common in [[elderly]] and its [[prevalence]] increase with age.<ref>{{Cite journal
  | author = [[Lindsay E. Nicolle]]
  | author = [[Lindsay E. Nicolle]]
  | title = Asymptomatic bacteriuria: when to screen and when to treat
  | title = Asymptomatic bacteriuria: when to screen and when to treat
Line 301: Line 311:
  | month = June
  | month = June
  | pmid = 12848475
  | pmid = 12848475
}}</ref>
}}</ref><ref>{{Cite journal
 
===Age===
*Asymptomatic bacteriuria is more common in [[elderly]] and its [[prevalence]] increase with age.<ref>{{Cite journal
  | author = [[Lindsay E. Nicolle]]
  | author = [[Lindsay E. Nicolle]]
  | title = Asymptomatic bacteriuria: when to screen and when to treat
  | title = Asymptomatic bacteriuria: when to screen and when to treat
Line 315: Line 322:
  | pmid = 12848475
  | pmid = 12848475
}}</ref>
}}</ref>
*The [[prevalence]] of asymptomatic bacteriuria in [[women]] greater than 80 years old is >20%.<ref>{{Cite journal
*The [[prevalence]] of asymptomatic bacteriuria in women greater than 80 years old is >20%.<ref>{{Cite journal
  | author = [[T. M. Hooton]], [[D. Scholes]], [[A. E. Stapleton]], [[P. L. Roberts]], [[C. Winter]], [[K. Gupta]], [[M. Samadpour]] & [[W. E. Stamm]]
  | author = [[T. M. Hooton]], [[D. Scholes]], [[A. E. Stapleton]], [[P. L. Roberts]], [[C. Winter]], [[K. Gupta]], [[M. Samadpour]] & [[W. E. Stamm]]
  | title = A prospective study of asymptomatic bacteriuria in sexually active young women
  | title = A prospective study of asymptomatic bacteriuria in sexually active young women
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  | pmid = 26542046
  | pmid = 26542046
}}</ref>
}}</ref>
*The [[prevalence]] of asymptomatic bacteriuria in [[men]] greater than 75 year old is 6 to 15%.<ref>{{Cite journal
*The [[prevalence]] of asymptomatic bacteriuria in men greater than 75 year old is 6-15%.<ref>{{Cite journal
  | author = [[Lindsay E. Nicolle]]
  | author = [[Lindsay E. Nicolle]]
  | title = Asymptomatic bacteriuria: when to screen and when to treat
  | title = Asymptomatic bacteriuria: when to screen and when to treat
Line 348: Line 355:
  | pmid = 12848475
  | pmid = 12848475
}}</ref>
}}</ref>
*Asymptomatic bacteriuria is present in 3-5% of the [[women]] population between 38-60 years of age. It was identified in 5% of women in universities and 6% of [[women]] in groups related to health maintenance organisations.<ref>{{Cite journal
*Asymptomatic bacteriuria is present in 3-5% of the women population between 38-60 years of age. It was identified in 5% of women in universities and 6% of [[women]] in groups related to health maintenance organisations.<ref>{{Cite journal
  | author = [[C. Bengtsson]], [[U. Bengtsson]], [[C. Bjorkelund]], [[K. Lincoln]] & [[J. A. Sigurdsson]]
  | author = [[C. Bengtsson]], [[U. Bengtsson]], [[C. Bjorkelund]], [[K. Lincoln]] & [[J. A. Sigurdsson]]
  | 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
  | 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
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===Gender===
===Gender===
*Asymptomatic bacteriuria is more prevalent in [[females]] as compared to [[males]]. Asymptomatic bacteriuria is rare among healthy [[men]].<ref>{{Cite journal
*Asymptomatic bacteriuria is more prevalent in [[females]] as compared to [[males]].  
*Asymptomatic bacteriuria is rare among healthy [[men]].<ref>{{Cite journal
  | author = [[C. M. Kunin]] & [[R. C. McCormack]]
  | author = [[C. M. Kunin]] & [[R. C. McCormack]]
  | title = An epidemiologic study of bacteriuria and blood pressure among nuns and working women
  | title = An epidemiologic study of bacteriuria and blood pressure among nuns and working women
Line 393: Line 401:
  | month = January
  | month = January
  | pmid = 2462391
  | pmid = 2462391
}}</ref>
*Asymptomatic bacteriuria has a [[prevalence]] of 8 to 14% in [[diabetic]] [[women]].<ref>{{Cite journal
| author = [[G. G. Zhanel]], [[L. E. Nicolle]] & [[G. K. Harding]]
| title = Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. The Manitoba Diabetic Urinary Infection Study Group
| journal = [[Clinical infectious diseases : an official publication of the Infectious Diseases Society of America]]
| volume = 21
| issue = 2
| pages = 316–322
| year = 1995
| month = August
| pmid = 8562738
}}</ref>
}}</ref>


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*[[Renal stones]]
*[[Renal stones]]
*[[Pregnant|Pregnancy]]<ref name="Nicolle-2003">{{Cite journal  | last1 = Nicolle | first1 = LE. | title = Asymptomatic bacteriuria: when to screen and when to treat. | journal = Infect Dis Clin North Am | volume = 17 | issue = 2 | pages = 367-94 | month = Jun | year = 2003 | doi =  | PMID = 12848475 }}</ref>  
*[[Pregnant|Pregnancy]]<ref name="Nicolle-2003">{{Cite journal  | last1 = Nicolle | first1 = LE. | title = Asymptomatic bacteriuria: when to screen and when to treat. | journal = Infect Dis Clin North Am | volume = 17 | issue = 2 | pages = 367-94 | month = Jun | year = 2003 | doi =  | PMID = 12848475 }}</ref>  
*[[Elderly]] <ref name="Nicolle-2003">{{Cite journal  | last1 = Nicolle | first1 = LE. | title = Asymptomatic bacteriuria: when to screen and when to treat. | journal = Infect Dis Clin North Am | volume = 17 | issue = 2 | pages = 367-94 | month = Jun | year = 2003 | doi =  | PMID = 12848475 }}</ref>
*[[Elderly]]  
*[[diabetes|Diabetes mellitus]]<ref name="Zhanel-">{{Cite journal  | last1 = Zhanel | first1 = GG. | last2 = Harding | first2 = GK. | last3 = Nicolle | first3 = LE. | title = Asymptomatic bacteriuria in patients with diabetes mellitus. | journal = Rev Infect Dis | volume = 13 | issue = 1 | pages = 150-4 | month =  | year =  | doi =  | PMID = 2017615 }}</ref>  
*[[diabetes|Diabetes mellitus]]<ref name="Zhanel-">{{Cite journal  | last1 = Zhanel | first1 = GG. | last2 = Harding | first2 = GK. | last3 = Nicolle | first3 = LE. | title = Asymptomatic bacteriuria in patients with diabetes mellitus. | journal = Rev Infect Dis | volume = 13 | issue = 1 | pages = 150-4 | month =  | year =  | doi =  | PMID = 2017615 }}</ref>  
*Patients with [[spinal cord injuries]]<ref name="Nicolle-1997">{{Cite journal  | last1 = Nicolle | first1 = LE. | title = Asymptomatic bacteriuria in the elderly. | journal = Infect Dis Clin North Am | volume = 11 | issue = 3 | pages = 647-62 | month = Sep | year = 1997 | doi =  | PMID = 9378928 }}</ref><ref name="Waites-1993">{{Cite journal  | last1 = Waites | first1 = KB. | last2 = Canupp | first2 = KC. | last3 = DeVivo | first3 = MJ. | title = Epidemiology and risk factors for urinary tract infection following spinal cord injury. | journal = Arch Phys Med Rehabil | volume = 74 | issue = 7 | pages = 691-5 | month = Jul | year = 1993 | doi =  | PMID = 8328888 }}</ref>  
*Patients with [[spinal cord injuries]]<ref name="Nicolle-1997">{{Cite journal  | last1 = Nicolle | first1 = LE. | title = Asymptomatic bacteriuria in the elderly. | journal = Infect Dis Clin North Am | volume = 11 | issue = 3 | pages = 647-62 | month = Sep | year = 1997 | doi =  | PMID = 9378928 }}</ref><ref name="Waites-1993">{{Cite journal  | last1 = Waites | first1 = KB. | last2 = Canupp | first2 = KC. | last3 = DeVivo | first3 = MJ. | title = Epidemiology and risk factors for urinary tract infection following spinal cord injury. | journal = Arch Phys Med Rehabil | volume = 74 | issue = 7 | pages = 691-5 | month = Jul | year = 1993 | doi =  | PMID = 8328888 }}</ref>  
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== Screening==
== Screening==
[[Screening]] for asymptomatic subjects is considered if [[bacteriuria]] is associated with preventable adverse outcomes such as symptomatic [[urinary infection]], progression to [[chronic kidney disease]] or [[hypertension]], development of urinary tract cancer, and decreased duration of survival.<ref name="pmid15714408" />
[[Screening]] for asymptomatic subjects is considered if [[bacteriuria]] is associated with preventable adverse outcomes such as symptomatic [[urinary infection]], progression to [[chronic kidney disease]] or [[hypertension]], development of urinary tract [[cancer]], and decreased duration of survival.<ref name="pmid15714408" />


===Individuals requiring screening===
===Individuals requiring screening===
The following should be screened for asymptomatic bacteriuria<ref>{{Cite journal
The following should be screened for asymptomatic bacteriuria:<ref>{{Cite journal
  | author = [[Kenneth Lin]] & [[Kevin Fajardo]]
  | author = [[Kenneth Lin]] & [[Kevin Fajardo]]
  | title = Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement
  | title = Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement
Line 483: Line 480:
}}</ref><ref name="Asymptomatic bacteriuria" />
}}</ref><ref name="Asymptomatic bacteriuria" />
*[[Pregnant]]
*[[Pregnant]]
*Requiring [[urologic procedures]] like [[transurethral resection of the prostate]] i.e [[TURP]]
*Requiring [[urologic procedures]] like [[transurethral resection of the prostate]] ([[TURP]])
*Post [[renal transplant]]
*Post [[renal transplant]]
===Catheter Associated Asymptomatic Bacteriuria===
===Catheter Associated Asymptomatic Bacteriuria===
It is not recommended to [[Screening|screen]] for or treat asymptomatic bacteriuria or fungiuria for short or long term [[catheters]],<ref name="Sobel-2000">{{Cite journal  |last1 = Sobel | first1 = JD. | last2 = Kauffman | first2 = CA. | last3 = McKinsey | first3 = D. | last4 = Zervos | first4 = M. | last5 = Vazquez | first5 = JA. |last6 = Karchmer | first6 = AW. | last7 = Lee | first7 = J. | last8 = Thomas | first8 = C. | last9 = Panzer | first9 = H. | title = Candiduria: a randomized, double-blind study of treatment with fluconazole and placebo. The National Institute of Allergy and Infectious Diseases (NIAID) Mycoses Study Group.| journal = Clin Infect Dis | volume = 30 | issue = 1 | pages = 19-24 | month = Jan | year = 2000 | doi = 10.1086/313580 | PMID = 10619727 }}</ref> exceptions are [[Catheterization|catheterized]] [[pregnant]] women and women with persistent [[bacteriuria]] 48 hours after removal of the [[Urethral catheterization|urethral catheter]]. Prophylaxis can also be used also with patients undergoing urological procedures.<ref name="Nicolle-2005">{{Cite journal  | last1 = Nicolle | first1 = LE. | last2 = Bradley | first2 = S. | last3 = Colgan | first3 = R. | last4 = Rice | first4 = JC. | last5 = Schaeffer | first5 = A. | last6 = Hooton | first6 = TM. | title = Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. | journal = Clin Infect Dis | volume = 40 | issue = 5 | pages = 643-54 | month = Mar | year = 2005 | doi = 10.1086/427507 | PMID = 15714408 }}</ref>
It is not recommended to [[Screening|screen]] for or treat asymptomatic bacteriuria or fungiuria for short or long term [[catheters]], exceptions are [[Catheterization|catheterized]] [[pregnant]] women and women with persistent [[bacteriuria]] 48 hours after removal of the [[Urethral catheterization|urethral catheter]]. Prophylaxis can also be used also with patients undergoing urological procedures.<ref name="Nicolle-2005">{{Cite journal  | last1 = Nicolle | first1 = LE. | last2 = Bradley | first2 = S. | last3 = Colgan | first3 = R. | last4 = Rice | first4 = JC. | last5 = Schaeffer | first5 = A. | last6 = Hooton | first6 = TM. | title = Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. | journal = Clin Infect Dis | volume = 40 | issue = 5 | pages = 643-54 | month = Mar | year = 2005 | doi = 10.1086/427507 | PMID = 15714408 }}</ref><ref name="Sobel-2000">{{Cite journal  |last1 = Sobel | first1 = JD. | last2 = Kauffman | first2 = CA. | last3 = McKinsey | first3 = D. | last4 = Zervos | first4 = M. | last5 = Vazquez | first5 = JA. |last6 = Karchmer | first6 = AW. | last7 = Lee | first7 = J. | last8 = Thomas | first8 = C. | last9 = Panzer | first9 = H. | title = Candiduria: a randomized, double-blind study of treatment with fluconazole and placebo. The National Institute of Allergy and Infectious Diseases (NIAID) Mycoses Study Group.| journal = Clin Infect Dis | volume = 30 | issue = 1 | pages = 19-24 | month = Jan | year = 2000 | doi = 10.1086/313580 | PMID = 10619727 }}</ref>


*No benefit of therapy of asymptomatic bacteriuria due to similar recurrence rates with more [[Drug resistance|resistance]] to [[antibiotics]].<ref name="Warren-1982">{{Cite journal  |last1 = Warren | first1 = JW. | last2 = Anthony | first2 = WC. | last3 = Hoopes | first3 = JM. | last4 = Muncie | first4 = HL. | title = Cephalexin for susceptible bacteriuria in afebrile, long-term catheterized patients. | journal = JAMA | volume = 248 | issue = 4 | pages = 454-8 | month = Jul | year = 1982|doi =  | PMID = 7045440 }}</ref><ref name="Alling-1975">{{Cite journal  | last1 = Alling | first1 = B. | last2 = Brandberg | first2 = A. | last3 = Seeberg|first3 = S. | last4 = Svanborg | first4 = A. | title = Effect of consecutive antibacterial therapy on bacteriuria in hospitalized geriatric patients. | journal = Scand J Infect Dis | volume = 7 | issue = 3 | pages = 201-7 | month =  | year = 1975 | doi =  | PMID = 809837 }}</ref>
*No benefit of therapy of asymptomatic bacteriuria due to similar recurrence rates with more [[Drug resistance|resistance]] to [[antibiotics]].<ref name="Warren-1982">{{Cite journal  |last1 = Warren | first1 = JW. | last2 = Anthony | first2 = WC. | last3 = Hoopes | first3 = JM. | last4 = Muncie | first4 = HL. | title = Cephalexin for susceptible bacteriuria in afebrile, long-term catheterized patients. | journal = JAMA | volume = 248 | issue = 4 | pages = 454-8 | month = Jul | year = 1982|doi =  | PMID = 7045440 }}</ref><ref name="Alling-1975">{{Cite journal  | last1 = Alling | first1 = B. | last2 = Brandberg | first2 = A. | last3 = Seeberg|first3 = S. | last4 = Svanborg | first4 = A. | title = Effect of consecutive antibacterial therapy on bacteriuria in hospitalized geriatric patients. | journal = Scand J Infect Dis | volume = 7 | issue = 3 | pages = 201-7 | month =  | year = 1975 | doi =  | PMID = 809837 }}</ref>
*Significant improvement has been shown with [[women]] treated for [[bacteriuria]] that existed 48 hours after removal of indwelling [[Urethral catheterization|urethral catheters]].<ref name="Harding-1991">{{Cite journal  | last1 = Harding | first1 = GK. | last2 = Nicolle | first2 = LE. | last3 = Ronald | first3 = AR. | last4 = Preiksaitis|first4 = JK. | last5 = Forward | first5 = KR. | last6 = Low | first6 = DE. | last7 = Cheang | first7 = M. | title = How long should catheter-acquired urinary tract infection in women be treated? A randomized controlled study. | journal = Ann Intern Med | volume = 114 | issue = 9 | pages = 713-9 | month = May | year = 1991 | doi =  | PMID = 2012351 }}</ref>
*Significant improvement has been shown with women treated for [[bacteriuria]] that existed 48 hours after removal of indwelling [[Urethral catheterization|urethral catheters]].<ref name="Harding-1991">{{Cite journal  | last1 = Harding | first1 = GK. | last2 = Nicolle | first2 = LE. | last3 = Ronald | first3 = AR. | last4 = Preiksaitis|first4 = JK. | last5 = Forward | first5 = KR. | last6 = Low | first6 = DE. | last7 = Cheang | first7 = M. | title = How long should catheter-acquired urinary tract infection in women be treated? A randomized controlled study. | journal = Ann Intern Med | volume = 114 | issue = 9 | pages = 713-9 | month = May | year = 1991 | doi =  | PMID = 2012351 }}</ref>


== Natural History, Complications, and Prognosis==
== Natural History, Complications, and Prognosis==

Revision as of 20:04, 18 June 2018

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To view the Urinary Tract Infections main page click here.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2], Abdurahman Khalil, M.D. [3]

Overview

Urine is normally sterile. Asymptomatic bacteriuria is a condition in which a significant number of bacteria appear in the urine, without the presence of typical symptoms of a urinary tract infection. Examples of such symptoms include burning during urination, frequent urination (frequency) and urgency. Presence of >10 leukocytes/mm³ is considered as pyuria but not asymptomatic bacteriuria unless the number exceeds ≥105 colony forming units(cfu)/mL.[1][2]

Definitions

According to the Infectious Disease Society of America (IDSA), asymptomatic bacteriuria is defined as the presence of ≥105 cfu/mL of bacteria in clean catch urine specimen of an asymptomatic person with respect to symptoms urinary tract infection. By definition, one positive sample is enough to confirm asymptomatic bacteriuria in men, whereas in women two consecutive samples with same organism are required to diagnose asymptomatic bacteriuria. In men or women who are catheterized and are asymptomatic, identification of ≥102 cfu/mL of a single organism in the catheterized specimen is defined as asymptomatic bacteriuria.[3][4]

Historical Perspective

Classification

Pathophysiology

Microbial Virulence

  • Asymptomatic bacteriuria may also be due to the decreased virulence of some strains that gather in the bladder but do not cause a symptomatic appearance. Some strains isolated from patients with asymptomatic bacteriuria in the setting of spinal cord injury have decreased capability of causing hemolysis.[9][10]

Host Factors

Causes

Most common organism

Common Causes Less Common Causes GU abnormalities & Hospitalization Long Term Catheterisation[17][18]
Enterococcus[19] Chromobacterium violaceum[20] E.coli[17][21] Pseudomonas aeruginosa
Enterobacteriaceae[22] Staphylococci[23] Proteus mirabilis[17][24] P. mirabilis
Klebsiella[25] Gardnerella vaginalis[26][27] Providencia stuartii
Pseudomonas aeruginosa[28] Elizabethkingia meningoseptica[29] Morganella morganii
Group B Streptococcus[30][31]

Differentiating Asymptomatic Bacteriuria From Other Diseases

UTI

As the name signifies, asymptomatic bacteriuria has no symptomatic presentation. It can be easily differentiated from other urinary tract infections in that they are identified by the presence of urinary symptoms including dysuria, hematuria, urgency, frequency and flank pain. Fever is also an important finding accompanying other urinary tract infections.

Pyuria

Asymptomatic bacteriuria should be differentiated from pyuria, which also signifies presence of an inflammatory response. Pyuria is the presence of excessive leukocytes in the urine. Less than 5 leukocytes are a normal finding in the urine whereas >15 leukocytes per 400x microscopic field in the urine sample are considered to be pyuria. Pyuria is not defined on the basis of colony forming units of the organism but exclusive on the number of leukocytes. Pyuria usually accompanies asymptomatic bacteriuria.[32]

Epidemiology and Demographics

Prevalance

Age

  • Asymptomatic bacteriuria is more common in elderly and its prevalence increase with age.[35][36]
  • The prevalence of asymptomatic bacteriuria in women greater than 80 years old is >20%.[37][38]
  • The prevalence of asymptomatic bacteriuria in men greater than 75 year old is 6-15%.[39]
  • Asymptomatic bacteriuria is present in 3-5% of the women population between 38-60 years of age. It was identified in 5% of women in universities and 6% of women in groups related to health maintenance organisations.[40][41]

Gender

  • Asymptomatic bacteriuria is more prevalent in females as compared to males.
  • Asymptomatic bacteriuria is rare among healthy men.[42][43]

Race

  • Asymptomatic bacteriuria has been slightly more common in black population.[44]

Risk Factors

Asymptomatic bacteriuria has risk factors similar to symptomatic bacteriuria. Some of these include:[45][46]

General Risk Factors

Disease Conditions

Screening

Screening for asymptomatic subjects is considered if bacteriuria is associated with preventable adverse outcomes such as symptomatic urinary infection, progression to chronic kidney disease or hypertension, development of urinary tract cancer, and decreased duration of survival.[4]

Individuals requiring screening

The following should be screened for asymptomatic bacteriuria:[54][55]

Catheter Associated Asymptomatic Bacteriuria

It is not recommended to screen for or treat asymptomatic bacteriuria or fungiuria for short or long term catheters, exceptions are catheterized pregnant women and women with persistent bacteriuria 48 hours after removal of the urethral catheter. Prophylaxis can also be used also with patients undergoing urological procedures.[56][57]

Natural History, Complications, and Prognosis

Natural History

Complications

Asymptomatic bacteriuria rarely leads to complications. These may include:

Prognosis

Asymptomatic bacteriuria has a good prognosis and completely resolves with treatment.[67]

Diagnosis

Diagnostic Study of Choice

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 to avoid false positivity due to bacterial growth.

The quantitative definition for significant bacteriuria is:[68]

  • 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.

History and Symptoms

Patients with asymptomatic bacteriuria are asymptomatic.

Physical Examination

Patients with asymptomatic bacteriuria appear completely normal.

Laboratory Findings

Electrocardiogram

There are no ECG findings associated with asymptomatic bacteriuria.

X-ray

There are no x-ray findings associated with asymptomatic bacteriuria.

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with asymptomatic bacteriuria.

CT scan

There are no CT scan findings associated with asymptomatic bacteriuria.

MRI

There are no MRI findings associated with asymptomatic bacteriuria.

Other Imaging Findings

There are no other imaging findings associated with asymptomatic bacteriuria.

Other Diagnostic Studies

There are no other diagnostic studies associated with asymptomatic bacteriuria.

Treatment

Medical Therapy

Treatment is not required in otherwise healthy individuals unless it is associated with a urinary tract infection. Some other conditions that might require the asymptomatic bacteriuria to be treated are:[78][79][80][55][81][82]

Asymptomatic bacteriuria treatment

  • 1. Empiric antimicrobial therapy
  • Treatment of asymptomatic bacteriuria is not recommended for the following persons:
  • 2. Specific considerations
  • 2.1 Women, pregnant
  • 2.2 Patients with indwelling urethral catheters
  • Screening for or treatment of asymptomatic bacteriuria in patients with indwelling urethral catheters is not recommended.
  • Note (1): Antimicrobial treatment of asymptomatic women with catheter-acquired bacteriuria that persists 48 hours after catheter removal may be considered.
  • 2.3 Urologic interventions
  • 2.4 Renal transplant
  • 2.5 Catheter Associated Asymptomatic Bacteriuria

Followup

  • A large proportion of women with asymptomatic bacteriuria in pregnancy have a recurrence after a short duration of therapy and for this reason a followup is done one week after completing the therapy and then monthly until the birth due to a higher chance of recurrence.[88]

Surgery

Surgical intervention is not recommended for the management of asymptomatic bacteriuria.

Primary Prevention

Primary preventive measure for asymptomatic bacteriuria include:[89][90]

Secondary Prevention

Secondary preventive measures for asymptomatic bacteriuria include:

References

  1. ↑ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001548/
  2. ↑ T. M. Hooton, D. Scholes, A. E. Stapleton, P. L. Roberts, C. Winter, K. Gupta, M. Samadpour & W. E. Stamm (2000). "A prospective study of asymptomatic bacteriuria in sexually active young women". The New England journal of medicine. 343 (14): 992–997. doi:10.1056/NEJM200010053431402. PMID 11018165. Unknown parameter |month= ignored (help)
  3. ↑ Rubin, RH.; Shapiro, ED.; Andriole, VT.; Davis, RJ.; Stamm, WE. (1992). "Evaluation of new anti-infective drugs for the treatment of urinary tract infection. Infectious Diseases Society of America and the Food and Drug Administration". Clin Infect Dis. 15 Suppl 1: S216–27. PMID 1477233. Unknown parameter |month= ignored (help)
  4. ↑ 4.0 4.1 Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM; et al. (2005). "Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults". Clin Infect Dis. 40 (5): 643–54. doi:10.1086/427507. PMID 15714408.
  5. ↑ KASS, EH. (1956). "Asymptomatic infections of the urinary tract". Trans Assoc Am Physicians. 69: 56–64. PMID 13380946.
  6. ↑ KASS, EH. (1957). "Bacteriuria and the diagnosis of infections of the urinary tract; with observations on the use of methionine as a urinary antiseptic". AMA Arch Intern Med. 100 (5): 709–14. PMID 13468815. Unknown parameter |month= ignored (help)
  7. ↑ E. H. KASS (1962). "Pyelonephritis and bacteriuria. A major problem in preventive medicine". Annals of internal medicine. 56: 46–53. PMID 14454174. Unknown parameter |month= ignored (help)
  8. ↑ Viktoria Roos, Eva M. Nielsen & Per Klemm (2006). "Asymptomatic bacteriuria Escherichia coli strains: adhesins, growth and competition". FEMS microbiology letters. 262 (1): 22–30. doi:10.1111/j.1574-6968.2006.00355.x. PMID 16907735. Unknown parameter |month= ignored (help)
  9. ↑ R. A. Hull, D. C. Rudy, I. E. Wieser & W. H. Donovan (1998). "Virulence factors of Escherichia coli isolates from patients with symptomatic and asymptomatic bacteriuria and neuropathic bladders due to spinal cord and brain injuries". Journal of clinical microbiology. 36 (1): 115–117. PMID 9431932. Unknown parameter |month= ignored (help)
  10. ↑ R. A. Hull, D. C. Rudy, W. H. Donovan, I. E. Wieser, C. Stewart & R. O. Darouiche (1999). "Virulence properties of Escherichia coli 83972, a prototype strain associated with asymptomatic bacteriuria". Infection and immunity. 67 (1): 429–432. PMID 9864249. Unknown parameter |month= ignored (help)
  11. ↑ Bryndis Ragnarsdottir, Martin Samuelsson, Mattias C. U. Gustafsson, Irene Leijonhufvud, Diana Karpman & Catharina Svanborg (2007). "Reduced toll-like receptor 4 expression in children with asymptomatic bacteriuria". The Journal of infectious diseases. 196 (3): 475–484. doi:10.1086/518893. PMID 17597463. Unknown parameter |month= ignored (help)
  12. ↑ Hans Fischer, Masahiro Yamamoto, Shizuo Akira, Bruce Beutler & Catharina Svanborg (2006). "Mechanism of pathogen-specific TLR4 activation in the mucosa: fimbriae, recognition receptors and adaptor protein selection". European journal of immunology. 36 (2): 267–277. doi:10.1002/eji.200535149. PMID 16385628. Unknown parameter |month= ignored (help)
  13. ↑ Evans DA, Williams DN, Laughlin LW, Miao L, Warren JW, Hennekens CH; et al. (1978). "Bacteriuria in a population-based cohort of women". J Infect Dis. 138 (6): 768–73. PMID 368263‎ Check |pmid= value (help).
  14. ↑ Kunin CM, McCormack RC (1968). "An epidemiologic study of bacteriuria and blood pressure among nuns and working women". N Engl J Med. 278 (12): 635–42. doi:10.1056/NEJM196803212781201. PMID 4866351.
  15. ↑ Bengtsson C, Bengtsson U, Björkelund C, Lincoln K, Sigurdsson JA (1998). "Bacteriuria in a population sample of women: 24-year follow-up study. Results from the prospective population-based study of women in Gothenburg, Sweden". Scand J Urol Nephrol. 32 (4): 284–9. PMID 9764457.
  16. ↑ Joseph Ayodeji Olamijulo, Chris Olu Adewale & Olalekan Olaleye (2016). "Asymptomatic bacteriuria among antenatal women in Lagos". Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 36 (6): 722–725. doi:10.3109/01443615.2016.1148675. PMID 26960990. Unknown parameter |month= ignored (help)
  17. ↑ 17.0 17.1 17.2 Nicolle LE (1997). "Asymptomatic bacteriuria in the elderly". Infect Dis Clin North Am. 11 (3): 647–62. PMID 9378928.
  18. ↑ Warren JW, Tenney JH, Hoopes JM, Muncie HL, Anthony WC (1982). "A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters". J Infect Dis. 146 (6): 719–23. PMID 6815281.
  19. ↑ A.-K. Labi, A. E. Yawson, G. Y. Ganyaglo & M. J. Newman (2015). "Prevalence and Associated Risk Factors of Asymptomatic Bacteriuria in Ante-Natal Clients in a Large Teaching Hospital in Ghana". Ghana medical journal. 49 (3): 154–158. PMID 26693190. Unknown parameter |month= ignored (help)
  20. ↑ Narayan Dutt Pant, Manisha Sharma & Saroj Khatiwada (2015). "Asymptomatic Bacteriuria Caused by Chromobacterium violaceum in an Immunocompetent Adult". Case reports in medicine. 2015: 652036. doi:10.1155/2015/652036. PMID 26504464.
  21. ↑ Joseph Ayodeji Olamijulo, Chris Olu Adewale & Olalekan Olaleye (2016). "Asymptomatic bacteriuria among antenatal women in Lagos". Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 36 (6): 722–725. doi:10.3109/01443615.2016.1148675. PMID 26960990. Unknown parameter |month= ignored (help)
  22. ↑ A.-K. Labi, A. E. Yawson, G. Y. Ganyaglo & M. J. Newman (2015). "Prevalence and Associated Risk Factors of Asymptomatic Bacteriuria in Ante-Natal Clients in a Large Teaching Hospital in Ghana". Ghana medical journal. 49 (3): 154–158. PMID 26693190. Unknown parameter |month= ignored (help)
  23. ↑ A. P. Roberts & R. Phillips (1979). "Bacteria causing symptomatic urinary tract infection or asymptomatic bacteriuria". Journal of clinical pathology. 32 (5): 492–496. PMID 381327. Unknown parameter |month= ignored (help)
  24. ↑ Joseph Ayodeji Olamijulo, Chris Olu Adewale & Olalekan Olaleye (2016). "Asymptomatic bacteriuria among antenatal women in Lagos". Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 36 (6): 722–725. doi:10.3109/01443615.2016.1148675. PMID 26960990. Unknown parameter |month= ignored (help)
  25. ↑ Joseph Ayodeji Olamijulo, Chris Olu Adewale & Olalekan Olaleye (2016). "Asymptomatic bacteriuria among antenatal women in Lagos". Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 36 (6): 722–725. doi:10.3109/01443615.2016.1148675. PMID 26960990. Unknown parameter |month= ignored (help)
  26. ↑ Lipsky BA, Inui TS, Plorde JJ, Berger RE (1984). "Is the clean-catch midstream void procedure necessary for obtaining urine culture specimens from men?". Am J Med. 76 (2): 257–62. PMID 6695949.
  27. ↑ Mims AD, Norman DC, Yamamura RH, Yoshikawa TT (1990). "Clinically inapparent (asymptomatic) bacteriuria in ambulatory elderly men: epidemiological, clinical, and microbiological findings". J Am Geriatr Soc. 38 (11): 1209–14. PMID 2246458.
  28. ↑ Richard Colgan, Lindsay E. Nicolle, Andrew McGlone & Thomas M. Hooton (2006). "Asymptomatic bacteriuria in adults". American family physician. 74 (6): 985–990. PMID 17002033. Unknown parameter |month= ignored (help)
  29. ↑ Zhiyong Zong (2014). "Elizabethkingia meningoseptica as an unusual pathogen causing healthcare-associated bacteriuria". Internal medicine (Tokyo, Japan). 53 (16): 1877–1879. PMID 25130129.
  30. ↑ Richard Colgan, Lindsay E. Nicolle, Andrew McGlone & Thomas M. Hooton (2006). "Asymptomatic bacteriuria in adults". American family physician. 74 (6): 985–990. PMID 17002033. Unknown parameter |month= ignored (help)
  31. ↑ Narayan Dutt Pant, Manisha Sharma & Saroj Khatiwada (2015). "Asymptomatic Bacteriuria Caused by Chromobacterium violaceum in an Immunocompetent Adult". Case reports in medicine. 2015: 652036. doi:10.1155/2015/652036. PMID 26504464.
  32. ↑ 32.0 32.1 Stamm, WE. (1983). "Measurement of pyuria and its relation to bacteriuria". Am J Med. 75 (1B): 53–8. PMID 6349345. Unknown parameter |month= ignored (help)
  33. ↑ C. M. Kunin & R. C. McCormack (1968). "An epidemiologic study of bacteriuria and blood pressure among nuns and working women". The New England journal of medicine. 278 (12): 635–642. doi:10.1056/NEJM196803212781201. PMID 4866351. Unknown parameter |month= ignored (help)
  34. ↑ G. G. Zhanel, L. E. Nicolle & G. K. Harding (1995). "Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. The Manitoba Diabetic Urinary Infection Study Group". Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 21 (2): 316–322. PMID 8562738. Unknown parameter |month= ignored (help)
  35. ↑ Lindsay E. Nicolle (2003). "Asymptomatic bacteriuria: when to screen and when to treat". Infectious disease clinics of North America. 17 (2): 367–394. PMID 12848475. Unknown parameter |month= ignored (help)
  36. ↑ Lindsay E. Nicolle (2003). "Asymptomatic bacteriuria: when to screen and when to treat". Infectious disease clinics of North America. 17 (2): 367–394. PMID 12848475. Unknown parameter |month= ignored (help)
  37. ↑ T. M. Hooton, D. Scholes, A. E. Stapleton, P. L. Roberts, C. Winter, K. Gupta, M. Samadpour & W. E. Stamm (2000). "A prospective study of asymptomatic bacteriuria in sexually active young women". The New England journal of medicine. 343 (14): 992–997. doi:10.1056/NEJM200010053431402. PMID 11018165. Unknown parameter |month= ignored (help)
  38. ↑ Lindsay E. Nicolle (2015). "Asymptomatic Bacteriuria and Bacterial Interference". Microbiology spectrum. 3 (5). doi:10.1128/microbiolspec.UTI-0001-2012. PMID 26542046. Unknown parameter |month= ignored (help)
  39. ↑ Lindsay E. Nicolle (2003). "Asymptomatic bacteriuria: when to screen and when to treat". Infectious disease clinics of North America. 17 (2): 367–394. PMID 12848475. Unknown parameter |month= ignored (help)
  40. ↑ C. Bengtsson, U. Bengtsson, C. Bjorkelund, K. Lincoln & J. A. Sigurdsson (1998). "Bacteriuria in a population sample of women: 24-year follow-up study. Results from the prospective population-based study of women in Gothenburg, Sweden". Scandinavian journal of urology and nephrology. 32 (4): 284–289. PMID 9764457. Unknown parameter |month= ignored (help)
  41. ↑ T. M. Hooton, D. Scholes, A. E. Stapleton, P. L. Roberts, C. Winter, K. Gupta, M. Samadpour & W. E. Stamm (2000). "A prospective study of asymptomatic bacteriuria in sexually active young women". The New England journal of medicine. 343 (14): 992–997. doi:10.1056/NEJM200010053431402. PMID 11018165. Unknown parameter |month= ignored (help)
  42. ↑ C. M. Kunin & R. C. McCormack (1968). "An epidemiologic study of bacteriuria and blood pressure among nuns and working women". The New England journal of medicine. 278 (12): 635–642. doi:10.1056/NEJM196803212781201. PMID 4866351. Unknown parameter |month= ignored (help)
  43. ↑ B. A. Lipsky (1989). "Urinary tract infections in men. Epidemiology, pathophysiology, diagnosis, and treatment". Annals of internal medicine. 110 (2): 138–150. PMID 2462391. Unknown parameter |month= ignored (help)
  44. ↑ R. Mittendorf, M. A. Williams & E. H. Kass (1992). "Prevention of preterm delivery and low birth weight associated with asymptomatic bacteriuria". Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 14 (4): 927–932. PMID 1533541. Unknown parameter |month= ignored (help)
  45. ↑ T. M. Hooton, D. Scholes, A. E. Stapleton, P. L. Roberts, C. Winter, K. Gupta, M. Samadpour & W. E. Stamm (2000). "A prospective study of asymptomatic bacteriuria in sexually active young women". The New England journal of medicine. 343 (14): 992–997. doi:10.1056/NEJM200010053431402. PMID 11018165. Unknown parameter |month= ignored (help)
  46. ↑ Konstanze Angelescu, Barbara Nussbaumer-Streit, Wiebke Sieben, Fulop Scheibler & Gerald Gartlehner (2016). "Benefits and harms of screening for and treatment of asymptomatic bacteriuria in pregnancy: a systematic review". BMC pregnancy and childbirth. 16 (1): 336. doi:10.1186/s12884-016-1128-0. PMID 27806709. Unknown parameter |month= ignored (help)
  47. ↑ Nicolle, LE. (2003). "Asymptomatic bacteriuria: when to screen and when to treat". Infect Dis Clin North Am. 17 (2): 367–94. PMID 12848475. Unknown parameter |month= ignored (help)
  48. ↑ Zhanel, GG.; Harding, GK.; Nicolle, LE. "Asymptomatic bacteriuria in patients with diabetes mellitus". Rev Infect Dis. 13 (1): 150–4. PMID 2017615.
  49. ↑ 49.0 49.1 Nicolle, LE. (1997). "Asymptomatic bacteriuria in the elderly". Infect Dis Clin North Am. 11 (3): 647–62. PMID 9378928. Unknown parameter |month= ignored (help)
  50. ↑ Waites, KB.; Canupp, KC.; DeVivo, MJ. (1993). "Epidemiology and risk factors for urinary tract infection following spinal cord injury". Arch Phys Med Rehabil. 74 (7): 691–5. PMID 8328888. Unknown parameter |month= ignored (help)
  51. ↑ Bakke, A.; Digranes, A. (1991). "Bacteriuria in patients treated with clean intermittent catheterization". Scand J Infect Dis. 23 (5): 577–82. PMID 1767253.
  52. ↑ 52.0 52.1 Chaudhry, A.; Stone, WJ.; Breyer, JA. (1993). "Occurrence of pyuria and bacteriuria in asymptomatic hemodialysis patients". Am J Kidney Dis. 21 (2): 180–3. PMID 8430679. Unknown parameter |month= ignored (help)
  53. ↑ Lindsay E. Nicolle (2003). "Asymptomatic bacteriuria: when to screen and when to treat". Infectious disease clinics of North America. 17 (2): 367–394. PMID 12848475. Unknown parameter |month= ignored (help)
  54. ↑ Kenneth Lin & Kevin Fajardo (2008). "Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement". Annals of internal medicine. 149 (1): W20–W24. PMID 18591632. Unknown parameter |month= ignored (help)
  55. ↑ 55.0 55.1 55.2 USPSTF https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/asymptomatic-bacteriuria-in-adults-screening?ds=1&s=asymptomatic%20bacteriuria Accessed on Feb 3, 2017
  56. ↑ Nicolle, LE.; Bradley, S.; Colgan, R.; Rice, JC.; Schaeffer, A.; Hooton, TM. (2005). "Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults". Clin Infect Dis. 40 (5): 643–54. doi:10.1086/427507. PMID 15714408. Unknown parameter |month= ignored (help)
  57. ↑ Sobel, JD.; Kauffman, CA.; McKinsey, D.; Zervos, M.; Vazquez, JA.; Karchmer, AW.; Lee, J.; Thomas, C.; Panzer, H. (2000). "Candiduria: a randomized, double-blind study of treatment with fluconazole and placebo. The National Institute of Allergy and Infectious Diseases (NIAID) Mycoses Study Group". Clin Infect Dis. 30 (1): 19–24. doi:10.1086/313580. PMID 10619727. Unknown parameter |month= ignored (help)
  58. ↑ Warren, JW.; Anthony, WC.; Hoopes, JM.; Muncie, HL. (1982). "Cephalexin for susceptible bacteriuria in afebrile, long-term catheterized patients". JAMA. 248 (4): 454–8. PMID 7045440. Unknown parameter |month= ignored (help)
  59. ↑ Alling, B.; Brandberg, A.; Seeberg, S.; Svanborg, A. (1975). "Effect of consecutive antibacterial therapy on bacteriuria in hospitalized geriatric patients". Scand J Infect Dis. 7 (3): 201–7. PMID 809837.
  60. ↑ Harding, GK.; Nicolle, LE.; Ronald, AR.; Preiksaitis, JK.; Forward, KR.; Low, DE.; Cheang, M. (1991). "How long should catheter-acquired urinary tract infection in women be treated? A randomized controlled study". Ann Intern Med. 114 (9): 713–9. PMID 2012351. Unknown parameter |month= ignored (help)
  61. ↑ Kenneth Lin & Kevin Fajardo (2008). "Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement". Annals of internal medicine. 149 (1): W20–W24. PMID 18591632. Unknown parameter |month= ignored (help)
  62. ↑ Anca Zalmanovici Trestioreanu, Adi Lador, May-Tal Sauerbrun-Cutler & Leonard Leibovici (2015). "Antibiotics for asymptomatic bacteriuria". The Cochrane database of systematic reviews. 4: CD009534. doi:10.1002/14651858.CD009534.pub2. PMID 25851268. Unknown parameter |month= ignored (help)
  63. ↑ R. Romero, E. Oyarzun, M. Mazor, M. Sirtori, J. C. Hobbins & M. Bracken (1989). "Meta-analysis of the relationship between asymptomatic bacteriuria and preterm delivery/low birth weight". Obstetrics and gynecology. 73 (4): 576–582. PMID 2927852. Unknown parameter |month= ignored (help)
  64. ↑ F. Smaill & J. C. Vazquez (2007). "Antibiotics for asymptomatic bacteriuria in pregnancy". The Cochrane database of systematic reviews (2): CD000490. doi:10.1002/14651858.CD000490.pub2. PMID 17443502. Unknown parameter |month= ignored (help)
  65. ↑ Kenneth Lin & Kevin Fajardo (2008). "Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement". Annals of internal medicine. 149 (1): W20–W24. PMID 18591632. Unknown parameter |month= ignored (help)
  66. ↑ Lindsay E. Nicolle (2015). "Asymptomatic Bacteriuria and Bacterial Interference". Microbiology spectrum. 3 (5). doi:10.1128/microbiolspec.UTI-0001-2012. PMID 26542046. Unknown parameter |month= ignored (help)
  67. ↑ Fiona M. Smaill & Juan C. Vazquez (2015). "Antibiotics for asymptomatic bacteriuria in pregnancy". The Cochrane database of systematic reviews (8): CD000490. doi:10.1002/14651858.CD000490.pub3. PMID 26252501. Unknown parameter |month= ignored (help)
  68. ↑ Rubin RH, Shapiro ED, Andriole VT, Davis RJ, Stamm WE (1992). "Evaluation of new anti-infective drugs for the treatment of urinary tract infection. Infectious Diseases Society of America and the Food and Drug Administration". Clin Infect Dis. 15 Suppl 1: S216–27. PMID 1477233.
  69. ↑ Richard Colgan, Lindsay E. Nicolle, Andrew McGlone & Thomas M. Hooton (2006). "Asymptomatic bacteriuria in adults". American family physician. 74 (6): 985–990. PMID 17002033. Unknown parameter |month= ignored (help)
  70. ↑ Nicolle, LE.; Duckworth, H.; Brunka, J.; Urias, B.; Kennedy, J.; Murray, D.; Harding, GK. (1998). "Urinary antibody level and survival in bacteriuric institutionalized older subjects". J Am Geriatr Soc. 46 (8): 947–53. PMID 9706881. Unknown parameter |month= ignored (help)
  71. ↑ Harding, GK.; Zhanel, GG.; Nicolle, LE.; Cheang, M. (2002). "Antimicrobial treatment in diabetic women with asymptomatic bacteriuria". N Engl J Med. 347 (20): 1576–83. doi:10.1056/NEJMoa021042. PMID 12432044. Unknown parameter |month= ignored (help)
  72. ↑ Darouiche, RO.; Cadle, RM.; Zenon, GJ.; Markowski, J.; Rodriguez, M.; Musher, DM. (1993). "Progression from asymptomatic to symptomatic urinary tract infection in patients with SCI: a preliminary study". J Am Paraplegia Soc. 16 (4): 219–24. PMID 8270918. Unknown parameter |month= ignored (help)
  73. ↑ Zhanel, GG.; Nicolle, LE.; Harding, GK. (1995). "Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. The Manitoba Diabetic Urinary Infection Study Group". Clin Infect Dis. 21 (2): 316–22. PMID 8562738. Unknown parameter |month= ignored (help)
  74. ↑ Bachman, JW.; Heise, RH.; Naessens, JM.; Timmerman, MG. (1993). "A study of various tests to detect asymptomatic urinary tract infections in an obstetric population". JAMA. 270 (16): 1971–4. PMID 8411555. Unknown parameter |month= ignored (help)
  75. ↑ KINCAID-SMITH, P.; BULLEN, M. (1965). "BACTERIURIA IN PREGNANCY". Lancet. 1 (7382): 395–9. PMID 14238090. Unknown parameter |month= ignored (help)
  76. ↑ Hooton, TM.; Scholes, D.; Stapleton, AE.; Roberts, PL.; Winter, C.; Gupta, K.; Samadpour, M.; Stamm, WE. (2000). "A prospective study of asymptomatic bacteriuria in sexually active young women". N Engl J Med. 343 (14): 992–7. doi:10.1056/NEJM200010053431402. PMID 11018165. Unknown parameter |month= ignored (help)
  77. ↑ T. M. Hooton, D. Scholes, A. E. Stapleton, P. L. Roberts, C. Winter, K. Gupta, M. Samadpour & W. E. Stamm (2000). "A prospective study of asymptomatic bacteriuria in sexually active young women". The New England journal of medicine. 343 (14): 992–997. doi:10.1056/NEJM200010053431402. PMID 11018165. Unknown parameter |month= ignored (help)
  78. ↑ Lindsay E. Nicolle, Suzanne Bradley, Richard Colgan, James C. Rice, Anthony Schaeffer & Thomas M. Hooton (2005). "Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults". Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 40 (5): 643–654. doi:10.1086/427507. PMID 15714408. Unknown parameter |month= ignored (help)
  79. ↑ Kenneth Lin & Kevin Fajardo (2008). "Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement". Annals of internal medicine. 149 (1): W20–W24. PMID 18591632. Unknown parameter |month= ignored (help)
  80. ↑ Andree Leduc (2014). "Reducing the treatment of asymptomatic bacteriuria in seniors in a long-term care facility". The Canadian nurse. 110 (7): 25–30. PMID 25920165. Unknown parameter |month= ignored (help)
  81. ↑ Nicolle, Lindsay E.; Bradley, Suzanne; Colgan, Richard; Rice, James C.; Schaeffer, Anthony; Hooton, Thomas M.; Infectious Diseases Society of America; American Society of Nephrology; American Geriatric Society (2005-03-01). "Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 40 (5): 643–654. doi:10.1086/427507. ISSN 1537-6591. PMID 15714408.
  82. ↑ "Guidelines on Urological Infections".
  83. ↑ "Guidelines on Urological Infections".
  84. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  85. ↑ D. ALEKSANDROW, W. WYSZNACKA, H. CHLEBUS, S. FILIPECKI, A. MICHAJLIK & M. RYCEROWA (1959). "[Remote results of the treatment of pyelonephritis]". Polskie Archiwum Medycyny Wewnetrznej. 29: 503–509. PMID 13792521.
  86. ↑ John R. Lee, Heejung Bang, Darshana Dadhania, Choli Hartono, Meredith J. Aull, Michael Satlin, Phyllis August, Manikkam Suthanthiran & Thangamani Muthukumar (2013). "Independent risk factors for urinary tract infection and for subsequent bacteremia or acute cellular rejection: a single-center report of 1166 kidney allograft recipients". Transplantation. 96 (8): 732–738. doi:10.1097/TP.0b013e3182a04997. PMID 23917724. Unknown parameter |month= ignored (help)
  87. ↑ Ella J. Ariza-Heredia, Elena N. Beam, Timothy G. Lesnick, Fernando G. Cosio, Walter K. Kremers & Raymund R. Razonable (2014). "Impact of urinary tract infection on allograft function after kidney transplantation". Clinical transplantation. 28 (6): 683–690. doi:10.1111/ctr.12366. PMID 24654771. Unknown parameter |month= ignored (help)
  88. ↑ T. F. Patterson & V. T. Andriole (1997). "Detection, significance, and therapy of bacteriuria in pregnancy. Update in the managed health care era". Infectious disease clinics of North America. 11 (3): 593–608. PMID 9378925. Unknown parameter |month= ignored (help)
  89. ↑ Kenneth Lin & Kevin Fajardo (2008). "Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement". Annals of internal medicine. 149 (1): W20–W24. PMID 18591632. Unknown parameter |month= ignored (help)
  90. ↑ H. H. Meyhoff, J. Nordling, P. A. Gammelgaard & R. Vejlsgaard (1981). "Does antibacterial ointment applied to urethral meatus in women prevent recurrent cystitis?". Scandinavian journal of urology and nephrology. 15 (2): 81–83. PMID 7036332.
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