Asymptomatic Bacteriuria in Noncatheterized Adults

Ferroni, Matthew C.; Taylor, Aisha

doi:10.1016/j.ucl.2015.07.003

Cited by 19 publications

(23 citation statements)

References 68 publications

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“…The most common pathogen is Escherichia coli, although other bacteria such as Klebsiella, Proteus mirabilis, and group B streptococcus can be involved. 4,11…”

Section: Definition Of Asymptomatic Bacteriuriamentioning

confidence: 99%

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Screening for Asymptomatic Bacteriuria in Adults

Owens

Davidson

Krist

et al. 2019

JAMA

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IMPORTANCE Among the general adult population, women (across all ages) have the highest prevalence of asymptomatic bacteriuria, although rates increase with age among both men and women. Asymptomatic bacteriuria is present in an estimated 1% to 6% of premenopausal women and an estimated 2% to 10% of pregnant women and is associated with pyelonephritis, one of the most common nonobstetric reasons for hospitalization in pregnant women. Among pregnant persons, pyelonephritis is associated with perinatal complications including septicemia, respiratory distress, low birth weight, and spontaneous preterm birth. OBJECTIVE To update its 2008 recommendation, the USPSTF commissioned a review of the evidence on potential benefits and harms of screening for and treatment of asymptomatic bacteriuria in adults, including pregnant persons. POPULATION This recommendation applies to community-dwelling adults 18 years and older and pregnant persons of any age without signs and symptoms of a urinary tract infection. EVIDENCE ASSESSMENT Based on a review of the evidence, the USPSTF concludes with moderate certainty that screening for and treatment of asymptomatic bacteriuria in pregnant persons has moderate net benefit in reducing perinatal complications. There is adequate evidence that pyelonephritis in pregnancy is associated with negative maternal outcomes and that treatment of screen-detected asymptomatic bacteriuria can reduce the incidence of pyelonephritis in pregnant persons. The USPSTF found adequate evidence of harms associated with treatment of asymptomatic bacteriuria (including adverse effects of antibiotic treatment and changes in the microbiome) to be at least small in magnitude. The USPSTF concludes with moderate certainty that screening for and treatment of asymptomatic bacteriuria in nonpregnant adults has no net benefit. The known harms associated with treatment include adverse effects of antibiotic use and changes to the microbiome. Based on these known harms, the USPSTF determined the overall harms to be at least small in this group. RECOMMENDATIONS The USPSTF recommends screening pregnant persons for asymptomatic bacteriuria using urine culture. (B recommendation) The USPSTF recommends against screening for asymptomatic bacteriuria in nonpregnant adults. (D recommendation)

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“…The most common pathogen is Escherichia coli, although other bacteria such as Klebsiella, Proteus mirabilis, and group B streptococcus can be involved. 4,11…”

Section: Definition Of Asymptomatic Bacteriuriamentioning

confidence: 99%

“…12 Persons with diabetes are also at increased risk of developing asymptomatic bacteriuria. 4,6 Screening Tests…”

Section: Assessment Of Riskmentioning

confidence: 99%

Screening for Asymptomatic Bacteriuria in Adults

Owens

Davidson

Krist

et al. 2019

JAMA

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“…Bacteriuria asimptomatică este foarte frecventă, în special în anumite grupuri, cum ar fi pacienţii cu cateter vezical (100% în cateter după prima lună) şi persoanele din centrele de sănătate (10-50%), şi creşte odată cu vârsta (15% la persoanele mai în vârstă de 75 de ani) (20). Dovezile ştiinţifice descurajează puternic tratamentul bacteriuriei asimptomatice, în afara cazurilor foarte specifice: femeile gravide, deoarece la acestea creşte riscul de a dezvolta pielonefrită acută în al treilea trimestru de sarcină, cu o înrăutăţire clară a morbidităţii şi mortalităţii materne şi fetale (21).…”

Section: Supradiagnosticarea Infecţiilorunclassified

Importanţa supradiagnosticării în medicina de familie. Cum minimalizăm riscurile?

Stănescu¹,

Grăjdeanu²,

Șerban³

et al. 2019

Ro Med J.

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“…Para realizar el diagnóstico de ITU debe existir además piuria, definido como 5 o más leucocitos por campo y cualquier signo o síntoma de infección. [22][23][24] Los síntomas que generalmente se presentan en esa población, son tales como: disreflexia autonómica, incremento de la espasticidad, nuevos episodios de incontinencia urinaria o su empeoramiento, orina fétida, con sedimento o dolor abdominal.…”

Section: Factores De Riesgounclassified

Infección Urinaria en Pacientes con Lesión Medular

Ospina-Galeano

Durán

2018

Urol Colomb

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ResumenLa micción es un proceso complejo, que requiere la coordinación entre el sistema nervioso central y periférico. La alteración en ése, aumenta el riesgo para que se produzcan infecciones complicadas y a largo plazo, daño renal. La alteración en el vaciado de la vejiga, obliga a que muchos de esos pacientes, realicen cateterismos intermitentes o sonda vesical permanente, aumentando el riesgo de infecciones polimicrobianas o por gérmenes multiresistentes. Algunos factores implicados en el desarrollo de las infecciones de esos pacientes, son el residuo postmiccional elevado, estasis urinario, litiasis vesical, uso de catéteres, además de las alteraciones en el sistema inmune y las capas de recubrimiento en la mucosa vesical. El diagnóstico de infección se realiza al encontrar: piuria y bacteriuria, según método de vaciado vesical, y un síntoma general que sugiera infección. Conclusión: Las infecciones urinarias en pacientes con lesión medular, deben ser tratadas de acuerdo a sensibilidades de la zona, siempre con la toma previa de un urocultivo y con un diagnóstico adecuado de infección urinaria, teniendo en cuenta las diferentes maniobras de evacuación de la vejiga. No están recomendados los tratamientos cortos ni el tratamiento de las bacteriurias asintomáticas. Una de las formas de prevenir las infecciones, está en evitar situaciones de riesgo como el estasis vesical, las presiones intravesicales elevadas y los vaciamientos incompletos. En la actualidad existen múltiples medicamentos para prevenir las infecciones urinarias, pero faltan estudios con evidencia de más peso y en pacientes con lesión medular, para que puedan ser recomendados.

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Asymptomatic Bacteriuria in Noncatheterized Adults

Cited by 19 publications

References 68 publications

Screening for Asymptomatic Bacteriuria in Adults

Screening for Asymptomatic Bacteriuria in Adults

Importanţa supradiagnosticării în medicina de familie. Cum minimalizăm riscurile?

Infección Urinaria en Pacientes con Lesión Medular

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