Asymptomatic Bacteriuria
What Is It?
When a significant number of bacteria show up in the urine, it usually means there is an infection somewhere in the urinary tract (kidneys, ureters, bladder, urethra). A urinary tract infection usually causes several symptoms, including pain or burning during urination.
In asymptomatic bacteriuria, large numbers of bacteria (at least 100,000 bacteria per milliliter) are present in the urine, but the patient has no symptoms of a urinary tract infection (asymptomatic means without symptoms). It is unclear why the bacteria don’t cause symptoms. It may be that asymptomatic bacteruria is caused by weaker (less “virulent”) organisms. The condition does not always need to be treated.
Asymptomatic bacteriuria is most common in women, and in patients with diabetes, the elderly, and in those with indwelling urinary catheters.
Prevention
You can help to prevent asymptomatic bacteriuria by drinking several glasses of water each day. This will discourage the growth of bacteria by flushing out your urinary tract. Drinking cranberry juice every day might also deter the growth of bacteria by making your urine more acidic, but this has not been definitively shown through adequate medical studes.
To prevent the spread of intestinal bacteria from the rectum to the urinary tract, women should always wipe toilet tissue from front to back after having a bowel movement.
Treatment
Antibiotic treatment for asymptomatic bacteriuria is recommended for the following groups of patients:
* Children
* Patients with obstruction or abnormal structure of the urinary tract
* Pregnant women
* Men about to undergo urologic or prostate surgery
* People who have had a kidney transplant
Most patients with asymptomatic bacteriuria are elderly women who do not require treatment. Although treatment often will clear the bacteria from the urine, the condition often returns. Your doctor will usually wait until the results of two urine cultures have confirmed the presence of bacteria before beginning treatment. At that point, your doctor will have been able to identify the type of bacteria and determine the most effective antibiotic to treat it. For patients with indwelling urinary catheters, the bacteriuria after treatment, therefore, antibiotic therapy might be withheld if patient has no symptoms. However, these patients must be monitored closely for the development of symptoms.
