Asymptomatic bacteriuria and candiduria in catheterised patients

What it is

In patients with a urinary catheter at home, do not obtain routine urinalysis or cultures, and do not treat asymptomatic bacteriuria. Asymptomatic candiduria follows the same rule with one more step: do not treat it with antifungal therapy, but do remove the catheter.

The same problem appears without a catheter in older women. In women age 70 and older the incidence of asymptomatic bacteriuria is 16% to 18%, and in chronically incontinent and disabled older adults rates may reach 43%.

How it is diagnosed

What decides treatment is the symptom, not the culture. The symptoms that raise concern for a urinary tract infection are acute dysuria, new or worsening urinary urgency or frequency, new incontinence, gross hematuria, and suprapubic or costovertebral angle tenderness. General malaise in the absence of these symptoms is unlikely to represent a urinary tract infection and unlikely to improve with antibiotic therapy.