Screening for asymptomatic bacteriuria

What it is

Asymptomatic bacteriuria is bacteriuria in a patient who has no urinary symptoms. It is common with age: in women age 70 and older the incidence is 16% to 18%, and in chronically incontinent and disabled older adults rates may reach 43%.

Causes and risk

The factors that may predispose a patient to cystitis, pyelonephritis, urethritis and asymptomatic bacteriuria are:

• Sexual activity
• Pregnancy
• Barrier contraceptives, the diaphragm among them
• Prior urinary tract instrumentation
• Urinary catheterization, both indwelling and intermittent
• Anatomic anomalies, congenital and acquired
• Bladder dysfunction

How it presents

It carries no symptoms of its own. The symptoms that instead 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 without any of these is unlikely to represent a urinary tract infection and is unlikely to improve with antibiotic therapy.