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Asymptomatic bacteriuria

Screening - asymptomatic bacteria

 

Most of the time, your urine is sterile. This means there is no bacteria growing. On the other hand, if you have symptoms of a bladder or kidney infection, bacteria will be present and growing in your urine.

Sometimes, your health care provider may check your urine for bacteria even when you do not have any symptoms. If enough bacteria are found in your urine, you have asymptomatic bacteriuria.

Causes

 

Asymptomatic bacteriuria occurs in a small number of healthy people. It affects women more often than men. The reasons for the lack of symptoms are not well understood.

You are more likely to have this problem if you:

  • Have a urinary catheter in place
  • Are female
  • Are pregnant
  • Are sexually active (in females)
  • Have long-term diabetes and are female
  • Are older adults
  • Have recently had a surgical procedure in your urinary tract

 

Symptoms

 

There are no symptoms of this problem.

If you have these symptoms, you may have a urinary tract infection but you DO NOT have asymptomatic bacteriuria.

  • Burning during urination
  • Increased urgency to urinate
  • Increased frequency of urination

 

Exams and Tests

 

To diagnose asymptomatic bacteriuria, a urine sample must be sent for a urine culture. Most people with no urinary tract symptoms do not need this test.

You may need a urine culture done as a screening test even without symptoms if:

  • You are pregnant
  • You have a surgery or procedure planned that involves bladder, prostate, or other parts of the urinary tract
  • In men, only one culture needs to show growth of bacteria
  • In women, two different cultures must show growth of bacteria

 

Treatment

 

Most people who have bacteria growing in their urine, but no symptoms, do not need treatment. This is because the bacteria are not causing any harm. In fact, treating most people with this problem may make it harder to treat infections in the future.

However, for some people getting a urinary tract infection is more likely or may cause more severe problems. As a result, treatment with antibiotics may be needed if:

  • You are pregnant.
  • You had a kidney transplant recently.
  • You are scheduled for surgery involving the prostate gland, the bladder and those with infected kidney stones.
  • Young children with reflux (backward movement of urine from the bladder into ureters or kidneys).

Without symptoms being present, even those who are older adults, have diabetes, or have a catheter in place, do not need treatment.

 

Possible Complications

 

If it is not treated, you may have a kidney infection if you are at high risk.

 

When to Contact a Medical Professional

 

Call your provider if you have:

  • Difficulty emptying your bladder
  • Fever
  • Flank or back pain
  • Pain with urination

You will need to be checked for a bladder or kidney infection.

 

 

References

Dull RB, Friedman SK, Risoldi ZM, Rice EC, Starlin RC, Destache CJ. Antimicrobial treatment of asymptomatic bacteriuria in noncatheterized adults: a systematic review. Pharmacotherapy. 2014;34(9):941-960. PMID: 24807583 www.ncbi.nlm.nih.gov/pubmed/24807583.

Schaeffer AJ, Matulewicz RS, Klumpp DJ. Infections of the urinary tract. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 12.

Zalmanovici Trestioreanu A, Lador A, Sauerbrun-Cutler MT, Leibovici L. Antibiotics for asymptomatic bacteriuria. Cochrane Database Syst Rev. 2015;4:CD009534. PMID: 25851268 www.ncbi.nlm.nih.gov/pubmed/25851268.

 
  • Male urinary system

    Male urinary system - illustration

    The urinary system is made up of the kidneys, ureters, urethra and bladder.

    Male urinary system

    illustration

  • Vesicoureteral reflux

    Vesicoureteral reflux - illustration

    When the ureters enter the bladder, they travel through the wall of the bladder for a distance in such a way that they create a tunnel so that a flap-like valve is created inside the bladder. This valve prevents urine from backing-up into the ureters and kidneys. In some children, the valves may be abnormal or the ureters in the bladder may not travel long enough in the bladder wall, which can cause vesicoureteral reflux. Vesicoureteral reflux is a condition that allows urine to go back up into the ureters and kidneys causing repeated urinary tract infections. The reflux of urine exposes the ureters and kidney to infection from bacteria and high-pressure, which is generated by the bladder during urination.  If left untreated, urinary infections can cause kidney damage and renal scarring with the loss of potential growth of the kidney and high blood pressure later in life. Vesicoureteral reflux is treated with antibiotics, and in severe cases surgically.

    Vesicoureteral reflux

    illustration

    • Male urinary system

      Male urinary system - illustration

      The urinary system is made up of the kidneys, ureters, urethra and bladder.

      Male urinary system

      illustration

    • Vesicoureteral reflux

      Vesicoureteral reflux - illustration

      When the ureters enter the bladder, they travel through the wall of the bladder for a distance in such a way that they create a tunnel so that a flap-like valve is created inside the bladder. This valve prevents urine from backing-up into the ureters and kidneys. In some children, the valves may be abnormal or the ureters in the bladder may not travel long enough in the bladder wall, which can cause vesicoureteral reflux. Vesicoureteral reflux is a condition that allows urine to go back up into the ureters and kidneys causing repeated urinary tract infections. The reflux of urine exposes the ureters and kidney to infection from bacteria and high-pressure, which is generated by the bladder during urination.  If left untreated, urinary infections can cause kidney damage and renal scarring with the loss of potential growth of the kidney and high blood pressure later in life. Vesicoureteral reflux is treated with antibiotics, and in severe cases surgically.

      Vesicoureteral reflux

      illustration

    A Closer Look

     

       

      Review Date: 7/22/2016

      Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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