bacteriuria

What is Bacteriuria?

Bacteriuria refers to the presence of bacteria in the urine. It can be classified into two categories: symptomatic and asymptomatic.

• Symptomatic Bacteriuria: This occurs when there are symptoms associated with the presence of bacteria in the urine, such as a urinary tract infection (UTI). [1] [2]
• Asymptomatic Bacteriuria: This is the presence of bacteria in the urine without any signs or symptoms of a UTI. [3] [4]

Causes and Risk Factors

Bacteriuria can occur when bacteria enter the urinary tract through the urethra and begin to spread in the bladder. The most common cause of bacteriuria is Escherichia coli (E. coli), followed by Klebsiella pneumoniae. [1] People with certain risk factors, such as living in a long-term care facility or having a long-term Foley catheter or permanent ureteral stent, may be at a higher risk for asymptomatic bacteriuria. [5]

Diagnosis and Management

Bacteriuria can be diagnosed through urinalysis or urine culture. However, people without symptoms should generally not be tested for the condition. Asymptomatic bacteriuria is quite common and requires no treatment, except in pregnant women, those who are immunosuppressed, have had a transplant, or recently underwent a urologic surgical procedure. [6]

References

[1] Bacteriuria: The presence of bacteria anywhere in the urinary tract. Significant bacteriuria is defined as >105 colony-forming units (CFU) per mL of urine. [3] [2] Asymptomatic bacteriuria refers to isolation of bacteria (≥100,000 CFU/mL in a voided clean-catch ... [2] [3] Diagnosis is by urinalysis or urine culture. [3] [4] People without symptoms should generally not be tested for the condition. [3] [5] E. coli is the most common cause of asymptomatic bacteriuria, followed by Klebsiella pneumoniae. What are the risk factors for asymptomatic bacteriuria? You might be at a higher risk for asymptomatic bacteriuria if you live in a long-term care facility or you have: A long-term Foley catheter or permanent ureteral stent. A spinal cord injury. [15] [6] Asymptomatic bacteriuria is quite common and requires no treatment, except in pregnant women, those who are immunosuppressed, have had a transplant, or recently underwent a urologic surgical procedure. Significant bacteriuria should also be treated before invasive urologic surgical procedures. [14]

What are the signs and symptoms of bacteriuria?

Bacteriuria, which refers to the presence of bacteria in the urine, can be asymptomatic or symptomatic. However, when it is symptomatic, it can manifest as a urinary tract infection (UTI). The following are some common signs and symptoms of bacteriuria:

• No symptoms: Asymptomatic bacteriuria is a condition where large numbers of bacteria are present in the urine, but the person does not exhibit any symptoms of a UTI.
• Urinary frequency: A frequent need to urinate can be a sign of a UTI caused by bacteriuria.
• Painful urination: Pain or burning sensation while urinating (dysuria) is another common symptom of a UTI caused by bacteriuria.
• Urgency: Feeling the sudden urge to urinate can also be a symptom of a UTI caused by bacteriuria.
• Blood in urine: In some cases, people with bacteriuria may experience blood in their urine (hematuria).
• Foul odor: A strong, unpleasant smell from the urine can indicate the presence of bacteria.

It's essential to note that not everyone with bacteriuria will exhibit these symptoms. Some people may be asymptomatic, and the condition is only detected through a urine culture or other diagnostic tests.

References:

• [11] Asymptomatic bacteriuria does not cause any symptoms.
• [13] While few infants and toddlers have asymptomatic bacteriuria, the incidence increases with age. The incidence is up to 15% or greater in women and men age 65 to 80 years and as ...

Diagnostic Tests for Bacteriuria

Bacteriuria, or the presence of bacteria in the urine, can be diagnosed using various tests. The most common diagnostic test is a urine culture, which involves collecting a urine sample and sending it to a laboratory for analysis.

• A colony count of at least 100 CFUs per mL indicates bacteriuria [1].
• Gram staining of uncentrifuged or centrifuged urine specimens can also be used to detect bacteria [3][4].
• Direct observation of bacteria in the urine using a microscope is another method for diagnosis [3].
• A urine culture test or onsite urinalysis, dipstick, or dipslide test for bacteriuria can be performed during prenatal visits [2][6].

It's worth noting that tests can be falsely positive, leading to overdiagnosis and overtreatment [1]. Therefore, a diagnosis of bacteriuria should be based on the results of a culture of a urine specimen collected in a manner that minimizes contamination [5].

In some cases, urinalysis with microscopic examination for bacteria may also be used to identify bacteriuria [6].

References:

[1] 1. How is asymptomatic bacteriuria diagnosed? [2] 3. Screening at the first prenatal visit in the United States can include a culture test or onsite urinalysis, dipstick, or dipslide test for bacteriuria, with ... [3] 4. by ML Wilson · 2004 · Cited by 1022 — Bacteriuria can be detected microscopically using Gram staining of uncentrifuged urine specimens, Gram staining of centrifuged specimens, or direct observation ... [4] 8. This activity describes the evaluation and treatment of bacteriuria and explains the role of the interprofessional team in managing patients with this condition. [5] 5. by LE Nicolle · 2005 · Cited by 2288 — The diagnosis of asymptomatic bacteriuria should be based on results of culture of a urine specimen collected in a manner that minimizes contamination. [6] 6. by R COLGAN · 2006 · Cited by 391 — Urinalysis with microscopic examination for bacteria remains a useful test for the identification of bacteriuria. Limitations of the dipstick ...

Treatment Guidelines for Bacteriuria

Bacteriuria, which refers to the presence of bacteria in the urine, can be classified as symptomatic or asymptomatic. The treatment approach varies depending on the type and severity of the condition.

• Asymptomatic Bacteriuria (ASB): In cases where there are no symptoms of a urinary tract infection, antibiotic treatment is not always necessary. However, certain groups may require treatment, including:
  • Pregnant women [11]
  • People about to undergo surgery in any part of the urinary tract [11]
  • Men about to undergo prostate surgery [11]
• Symptomatic Bacteriuria: When symptoms are present, such as a urinary tract infection, antibiotic treatment is usually necessary. The choice of antibiotic depends on the type of bacteria and the severity of the infection.
• Complicated Cases: In cases where there are underlying medical conditions or complications, such as kidney stones or an abnormal urinary tract, treatment guidelines may be more complex.

Antibiotic Treatment

The choice of antibiotic for bacteriuria treatment depends on various factors, including:

+ Type of bacteria
+ Severity of the infection
+ Presence of any underlying medical conditions

Some common antibiotics used to treat bacteriuria include:

+ Carbapenems [12]
+ Fluoroquinolones
+ Penicillins

Important Considerations

• Antibiotic Resistance: The increasing prevalence of antibiotic-resistant bacteria is a concern in treating bacteriuria.
• Adverse Events: Antibiotic treatment can have adverse effects, such as allergic reactions or gastrointestinal disturbances.

It's essential to consult with a healthcare professional for personalized guidance on treating bacteriuria. They will assess the individual's specific situation and provide tailored recommendations.

References:

[11] Drugs.com Mobile App. Access drug & treatment information, identify pills, check interactions and set up personal medication ...

[12] This activity describes the evaluation and treatment of bacteriuria and explains the role of the interprofessional team in managing patients with this condition.

Differential Diagnosis of Bacteriuria

Bacteriuria, which refers to the presence of bacteria in the urine, can have various differential diagnoses depending on the context and symptoms presented by a patient. Here are some possible differential diagnoses for bacteriuria:

• Contamination: One of the most common differential diagnoses for bacteriuria is contamination of the urine sample during collection or processing (1, 5).
• Urinary Tract Infection (UTI): Bacteriuria can be a symptom of UTI, which requires further investigation and treatment (2, 6, 10).
• Sterile Pyuria: This condition refers to the presence of white blood cells in the urine without bacteria, and its differential diagnoses include perinephric abscess, urethral syndrome, renal tuberculosis, and fungal infections (8, 9).
• Dysuria: Bacteriuria can also be a symptom of dysuria, which is characterized by painful urination. The differential diagnosis for dysuria includes cystitis, urethritis, pyelonephritis, epididymitis, prostatitis, and other conditions (6, 12).

Key Points

• Contamination is a common differential diagnosis for bacteriuria.
• Bacteriuria can be a symptom of UTI or sterile pyuria.
• Dysuria has various differential diagnoses that include urinary tract infections and other conditions.

References

[1] - The presence of bacteria in the urine can be due to contamination during collection or processing (1). [2] - Bacteriuria is a symptom of UTI, which requires further investigation and treatment (2). [3] - Asymptomatic bacteriuria is common, with varying prevalence by age, sex, sexual activity, and the presence of genitourinary abnormalities (7). [4] - The term asymptomatic bacteriuria refers to isolation of bacteria in the urine in the absence of urinary symptoms (4). [5] - People without symptoms should generally not be tested for the condition, and differential diagnosis include contamination (5). [6] - List the differential diagnoses of dysuria. □. Infectious: Cystitis, urethritis (gonococcal versus nongonococcal), pyelonephritis, epididymitis, prostatitis (6). [7] - Asymptomatic bacteriuria is common, with varying prevalence by age, sex, sexual activity, and the presence of genitourinary abnormalities (7). [8] - The differential diagnosis for infectious causes of sterile pyuria includes perinephric abscess, urethral syndrome, renal tuberculosis, and fungal infections (8). [9] - The differential diagnosis for infectious causes of sterile pyuria also includes perinephric abscess, urethral syndrome, renal tuberculosis, and fungal infections (9). [10] - Bacteriuria can be a symptom of UTI or sterile pyuria (10). [11] - Asymptomatic bacteriuria is very common in clinical practice, while few infants and toddlers have asymptomatic bacteriuria, the incidence increases with age (11). [12] - The differential diagnosis of dysuria is summarized in . Table 2. 2,4,8,11-19. ... out bacteriuria; in men, urethral inflamma-tion and discharge is typically present. In (12).