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19.3
TOPIC OUTLINE
Approach to the adult with asymptomatic bacteriuria
INTRODUCTION
Authors Section Editor Deputy Editor
CLINICAL DEFINITIONS
Thomas Fekete, MD Stephen B Elinor L Baron, MD,
Voided clean catch specimens
Thomas M Hooton, Calderwood, MD DTMH
- Women MD
- Men
Catheterized specimens Disclosures
EPIDEMIOLOGY
Women Last literature review version 19.3: Fri Sep 30 00:00:00
Men GMT 2011 | This topic last updated: Tue Apr 20 00:00:00
GMT 2010 (More)
PATHOPHYSIOLOGY
INTRODUCTION Asymptomatic bacteriuria is defined as
WHOM TO TREAT
isolation of a specified quantitative count of bacteria in an
Pregnancy
appropriately collected urine specimen from an individual
Urologic intervention
without symptoms or signs of urinary tract infection. This topic
Hip arthroplasty
will outline the epidemiology, pathophysiology, clinical
WHOM NOT TO TREAT definitions, and approach to management in specific clinical
Women (premenopausal, circumstances.
nonpregnant)
Diabetic patients CLINICAL DEFINITIONS Urine is normally sterile but can
be a good growth medium for bacteria that enter the bladder
Spinal cord injury
and are not eliminated. Because of the difficulty in obtaining
Indwelling urethral catheters
uncontaminated voided midstream urine specimens,
Elderly in the community
quantitative thresholds have been established to distinguish
Elderly in health care facilities
bladder bacteriuria from urethral contamination.
SUMMARY AND Asymptomatic bacteriuria is defined as isolation of a specified
RECOMMENDATIONS quantitative count of bacteria in an appropriately collected
REFERENCES urine specimen from an individual without symptoms or signs
of urinary tract infection. The quantitative thresholds are
RELATED TOPICS
different for voided clean catch specimens and catheterized
Acute uncomplicated cystitis, specimens.
pyelonephritis, and asymptomatic
bacteriuria in men The presence of pyuria (10 leukocytes/mm3 of
uncentrifuged urine) is not sufficient for diagnosis of
Asymptomatic bacteriuria in
patients with diabetes mellitus bacteriuria [1-3]. This was illustrated in a study of urine
samples from asymptomatic elderly women; 60 percent of
Bacterial adherence and other
samples with pyuria had no bacteriuria [2].
virulence factors for urinary tract
infection Voided clean catch specimens Diagnostic criteria for
Medical care of the nursing home clean catch specimens including number of specimens and
patient in the United States minimum quantitative bacteria counts are outlined for women
Overview of control measures to and men below.
prevent surgical site infection Women Asymptomatic bacteriuria in women is defined
Toll-like receptors: Roles in disease by the 2005 Infectious Diseases Society of America (IDSA)
and therapy guidelines as two consecutive clean-catch voided urine
Urinary tract infection associated specimens with isolation of the same organism in quantitative
with urethral catheters counts of 10(5) cfu/mL [4].
Urinary tract infections and This definition is based upon studies of voided and
asymptomatic bacteriuria in
catheterized urine specimens from asymptomatic patients [5-
pregnancy
9]. A bacterial count of 10(5) cfu/mL in a catheterized
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REFERENCES
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