1887
No metrics data to plot.
The attempt to load metrics for this article has failed.
The attempt to plot a graph for these metrics has failed.

Asymptomatic Bacteriuria and Bacterial Interference

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.
Buy this Microbiology Spectrum Article
Price Non-Member $15.00
  • Author: Lindsay E. Nicolle1
  • Editors: Matthew A. Mulvey2, Ann E. Stapleton3, David J. Klumpp4
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Department of Internal Medicine and Medical Microbiology, University of Manitoba, Winnipeg, MB, R3T 2N2 Canada; 2: University of Utah, Salt Lake City, UT; 3: University of Washington, Seattle, WA; 4: Northwestern University, Chicago, IL
  • Source: microbiolspec September 2015 vol. 3 no. 5 doi:10.1128/microbiolspec.UTI-0001-2012
  • Received 29 June 2012 Accepted 03 April 2015 Published 04 September 2015
  • Lindsay E. Nicolle. lnicolle@hsc.mb.ca
image of Asymptomatic Bacteriuria and Bacterial Interference
    Preview this microbiology spectrum article:
    Zoom in
    Zoomout

    Asymptomatic Bacteriuria and Bacterial Interference, Page 1 of 2

    | /docserver/preview/fulltext/microbiolspec/3/5/UTI-0001-2012-1.gif /docserver/preview/fulltext/microbiolspec/3/5/UTI-0001-2012-2.gif
  • Abstract:

    Asymptomatic bacteriuria is very common. In healthy women, asymptomatic bacteriuria increases with age, from <1% in newborns to 10% to 20% of women age 80 years, but is uncommon in men until after age 50 years. Individuals with underlying genitourinary abnormalities, including indwelling devices, may also have a high frequency of asymptomatic bacteriuria, irrespective of age or gender. The prevalence is very high in residents of long-term–care facilities, from 25% to 50% of women and 15% to 40% of men. is the most frequent organism isolated, but a wide variety of other organisms may occur. Bacteriuria may be transient or persist for a prolonged period. Pregnant women with asymptomatic bacteriuria identified in early pregnancy and who are untreated have a risk of pyelonephritis later in pregnancy of 20% to 30%. Bacteremia is frequent in bacteriuric subjects following mucosal trauma with bleeding, with 5% to 10% of patients developing severe sepsis or septic shock. These two groups with clear evidence of negative outcomes should be screened for bacteriuria and appropriately treated. Asymptomatic bacteriuria in other populations is benign and screening and treatment are not indicated. Antimicrobial treatment has no benefits but is associated with negative outcomes including reinfection with antimicrobial resistant organisms and a short-term increased frequency of symptomatic infection post-treatment. The observation of increased symptomatic infection post-treatment, however, has led to active investigation of bacterial interference as a strategy to prevent symptomatic episodes in selected high risk patients.

  • Citation: Nicolle L. 2015. Asymptomatic Bacteriuria and Bacterial Interference. Microbiol Spectrum 3(5):UTI-0001-2012. doi:10.1128/microbiolspec.UTI-0001-2012.

Key Concept Ranking

Urinary Tract Infections
0.750109
Asymptomatic Bacteriuria
0.60090303
Type 1 Fimbriae
0.44924498
Tumor Necrosis Factor
0.4296621
0.750109

References

1. Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. 2005. IDSA Guideline for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 40:643–654. [PubMed][CrossRef]
2. Kass EH. 1956. Asymptomatic infections of the urinary tract. Trans Assoc Amer Phys 69:56–64. [PubMed]
3. Kass EH. 1957. Bacteriuria and the diagnosis of infections of the urinary tract. Arch Intern Med 100:709–714. [PubMed][CrossRef]
4. Kass EH. 1962. Pyelonephritis and bacteriuria: A major problem in preventive medicine. Ann Intern Med 56:46–53. [PubMed][CrossRef]
5. Beard RW, McCoy DR, Newton JR, Clayton SG. 1965. Diagnosis of urinary infection by suprapubic bladder puncture. Lancet ii:610–611. [PubMed][CrossRef]
6. Stamey TA, Govan DE, Palmer JM. 1965. The localization and treatment of urinary tract infections: The role of bactericidal urine levels as opposed to serum levels. Medicine (Baltimore) 44:1–36. [PubMed][CrossRef]
7. Platt R. 1983. Quantitative definition of bacteriuria. Am J Med 75(1B):44–52. [PubMed][CrossRef]
8. Kunin CM, White LV, Hua TH. 1993. A reassessment of importance of “low count” bacteriuria in young women with acute urinary symptoms. Ann Intern Med 119:454–460. [PubMed][CrossRef]
9. Savage WE, Hajj SN, Kass EH. 1967. Demographic and prognostic characteristics of bacteriuria in pregnancy. Medicine 46:385–407. [PubMed][CrossRef]
10. Leisure MK, Dudley SM, Donowitz LG. 1993. Does a clean-catch urine sample reduce bacterial contamination? N Engl J Med 328:289–290. [PubMed][CrossRef]
11. Roberts AP, Robinson RE, Beard RW. 1967. Some factors affecting bacterial colony counts in urinary infection. BMJ 1:400–403. [PubMed][CrossRef]
12. Kunin CM, McCormack RC. 1968. An epidemiologic study of bacteriuria and blood pressure among nuns and working women. N Engl J Med 278:635–642. [PubMed][CrossRef]
13. Kunin CM, Deutscher R, Paquin A. 1964. Urinary tract infection in school children: An epidemiologic, clinical and laboratory study. Medicine (Baltimore) 43:91–130. [PubMed]
14. Kaitz AL, Hodder EW. 1961. Bacteriuria and pyelonephritis of pregnancy. N Engl J Med 265:667–672. [PubMed][CrossRef]
15. Stenqvist K, Kahlen-Nilsson I, Lidin-Janson G, Lincoln K, Oden A, Bignell S, Svanborg-Eden C. 1989. Bacteriuria in pregnancy. Frequency and risk of acquisition. Amer J Epidemiol 129:372–379. [PubMed]
16. Hooton TM, Scholes D, Stapleton AE, Roberts PL, Winter C, Gupta K, Samadpour M, Stamm WE. 2000. A prospective study of asymptomatic bacteriuria in sexually active young women. N Engl J Med 343:992–997. [PubMed][CrossRef]
17. Takala J, Jausimes H, Sievers K. 1977. Screening for and treatment of bacteriuria in a middle aged female population. Acta Med Scand 202:69–73. [PubMed][CrossRef]
18. Harding GKM, Zhanel GG, Nicolle LE, Cheang M. 2002. Antimicrobial treatment in diabetic women with asymptomatic bacteriuria. N Engl J Med 347:1576–1583. [PubMed][CrossRef]
19. Geerlings SE, Brouwer EC, Gaastra W, Hopelman AIM. 2000. Is a second urine specimen necessary for the diagnosis of asymptomatic bacteriuria? Clin Infect Dis 31:e3–4. [PubMed][CrossRef]
20. Rodhe N, Lofgren S, Matussek A, Andre M, Englund L, Kuhn I, Molstad S. 2008. Asymptomatic bacteriuria in the elderly. High prevalence and high turnover of strains. Scand J Infect Dis 26:1–7. [CrossRef]
21. Nicolle LE, Mayhew WJ, Bryan L. 1987. Prospective, randomized comparison of therapy and no therapy for asymptomatic bacteriuria in institutionalized women. Amer J Med 8:27–33. [CrossRef]
22. Hedin K, Petersson C, Wideback K, Kahlmeter G, Molstad S. 2002. Asymptomatic bacteriuria in a population of elderly in municipal institutional care. Scand J Prim Health Care 20:166–168. [PubMed][CrossRef]
23. Lipsky BA, Inui TS, Plorde JJ, Berger RE. 1984. Is the clean-catch midstream void procedure necessary for obtaining urine culture specimens from men. Amer J Med 76:257–262. [PubMed][CrossRef]
24. Ouslander JG, Greengold BA, Silverblatt FJ, Garcia JP. 1987. An accurate method to obtain urine for culture in men with external catheters. Arch Intern Med 147:286–288. [PubMed][CrossRef]
25. Nicolle LE, Harding GKM, Kennedy J, McIntyre M, Aoki F, Murray D. 1988. Urine specimen collection with external devices for diagnosis of bacteriuria in elderly incontinent men. J Clin Microbiol 26:1115–1119. [PubMed]
26. Deresinski SC, Perkash I. 1985. Urinary tract infections in male spinal cord injured patients. Part one: Bacteriologic diagnosis. J Amer Paraplegia Soc 8:4–6. [PubMed]
27. Gleckman R, Esposito A, Crowly M, Natsios G. 1979. Rehability of a single urine culture in establishing diagnosis of asymptomatic bacteriuria in adult males. J Clin Microbiol 9:596–597. [PubMed]
28. Freedman LR, Phair JP, Seki M, Hamilton HB, Nefzger MD. 1965. The epidemiology of urinary tract infections in Hiroshema. Yale J Biol Med 37:262–282. [PubMed]
29. Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE, Rice JC, Saint S, Schaeffer AJ, Tambyah PA, Tenke P, Nicolle LE. 2010. Diagnosis, prevention and treatment of catheter associated urinary tract infection in adults. 2009 International Clinical Practice Guidelines. Clin Infect Dis 50:625–683. [PubMed][CrossRef]
30. Gribble MJ, McCallum NM, Schechter MT. 1988. Evaluation of diagnostic criteria for bacteriuria in acutely spinal cord injured patients undergoing intermittent catheterization. Diagn Microbiol Infect Dis 9:197–206. [PubMed][CrossRef]
31. Saint S, Chemoweth CE. 2003. Biofilms and catheter-associated urinary tract infections. Infect Dis Clin N Amer 17:411–432. [PubMed][CrossRef]
32. Stark RP, Marki DG. 1984. Bacteriuria in the catheterized patient: What quantitative level of bacteriuria is relevant. N Engl J Med 311:560–564. [PubMed][CrossRef]
33. Tenney JH, Warren JW. 1988. Bacteriuria in women with long term catheters: Paired comparison of indwelling and replacement catheters. J Infect Dis 157:199–202. [PubMed][CrossRef]
34. Bergquist D, Bronnestam R, Hedelin H, Stahl A. 1980. The relevance of urinary sampling methods in patients with indwelling Foley catheters. Brit J Urol 52:91–95.
35. Grahn D, Norman DC, White ML, Cantrell M, Yoshikawa TT. 1985. Validity of urinary catheter specimen for diagnosis of urinary tract infection in the elderly. Arch Intern Med 145:1858–1860. [PubMed][CrossRef]
36. Tenney JH, Warren JW. 1987. Long-term catheter-associated bacteriuria: species at low concentration. Urology 30:444–446. [PubMed][CrossRef]
37. Zhanel GG, Nicolle LE, Harding GKM. 1995. Prevalence of asymptomatic bacteriuria in women with diabetes mellitus. Clin Infect Dis 21:316–322. [PubMed][CrossRef]
38. Boscia JA, Abrutyn E, Levison ME, Pitsakis PG, Kaye D. 1989. Pyuria and asymptomatic bacteriuria in elderly ambulatory women. Ann Intern Med 110:404–405. [PubMed][CrossRef]
39. Ouslander JG, Schapira M, Schnelle J, Fingold S. 1996. Pyuria among chronically incontinent but otherwise asymptomatic nursing home residents. J Am Geriatr Soc 44:420–423. [PubMed][CrossRef]
40. Nicolle LE, Duckworth H, Brunka J, Urias B, Kennedy J, Murray D, Harding GKM. 1998. Urinary antibody level and survival in bacteriuric institutionalized elderly subjects. J Am Geriatr Soc 46:947–953. [PubMed][CrossRef]
41. Tambyah PA, Maki DG. 2000. The relationship between pyuria and infection in patients with indwelling urinary catheters. Arch Intern Med 160:673–682. [PubMed][CrossRef]
42. Steward DK, Wood GL, Cohen RL, Smith JW, Mackowiak PA. 1985. Failure of the urinalysis and quantitative urine culture in diagnosing symptomatic urinary tract infections in patients with long-term urinary catheters. Am J Infect Control 13:154–160. [PubMed][CrossRef]
43. Hedges S, Stenqvist K, Lidin-Janson G, Martinell J, Sandberg T, Svanbork C. 1992. Comparison of urine and serum concentrations of interleukin-6 in women with acute pyelonephritis or asymptomatic bacteriuria. J Infect Dis 166:653–656. [PubMed][CrossRef]
44. Hawn TR, Scholes D, Wang H, Li SS, Stapleton AE, Janer M, Aderem A, Stamm WE, Zhao LP, Hooton TM. 2009. Genetic variation of the human urinary tract innate immune response and asymptomatic bacteriuria in women. PLoS ONE 4:e300. [PubMed][CrossRef]
45. Hernandez JG, Sunden F, Connolly J, Svanborg C, Wullt B. 2011. Genetic control of the variable innate immune response to asymptomatic bacteriuria. PLoS ONE 6:e28289. [PubMed][CrossRef]
46. Rodhe N, Lofgren S, Strindhall J, Matussek A, Molstad S. 2009. Cytokines in urine in elderly subjects with acute cystitis and asymptomatic bacteriuria. Scand J Primary Health Care 27:74–79. [PubMed][CrossRef]
47. Nicolle LE, Brunka J, Orr P, Wilkins J, Harding GKM. 1993. Urinary immunoreactive interleukin–1 ∝ and interleukin–6 in bacteriuric institutionalized elderly subjects. J Urol 149:1049–1053. [PubMed]
48. Nicolle LE. 2003. Asymptomatic bacteriuria: When to screen and when to treat. Infect Dis Clin North Am 17:367–394. [PubMed][CrossRef]
49. Nicolle LE. 2009. Urinary tract infections in the elderly. Clin Geriatr Med 25:423–436. [PubMed][CrossRef]
50. Rodhe N, Molstad S, Englund L, Svardsudd K. 2006. Asymptomatic bacteriuria in a population of elderly residents living in a community setting: prevalence, characteristics and associated factors. Family Practice 23:303–307. [PubMed][CrossRef]
51. Nicolle LE, Bjornson J, Harding GKM, MacDonell JA. 1983. Bacteriuria in elderly institutionalized men. N Engl J Med 309:1420–1426. [PubMed][CrossRef]
52. Bakke A, Digranes A. 1991. Bacteriuria in patients treated with clean intermittent catheterization. Scand J Infect Dis 23:577–582. [PubMed][CrossRef]
53. Waites KB, Canupp KC, De Vivo MJ. 1993. Epidemiology and risk factors for urinary tract infection following spinal cord injury. Arch Phys Med Rehabil 74:691–695. [PubMed][CrossRef]
54. Riedl CR, Plas E, Hubner WA, Zimmer H, Ulrish W, Pfluger H. 1999. Bacterial colonization of urethral stents. Eur Urol 36:53–59. [PubMed][CrossRef]
55. Kehinde EO, Rotimi VO, Al-Hunayan A, Abdul-Halim H, Boland F, Al-Awadi KA. 2004. Bacteriology of urinary tract infection associated with indwelling J ureteral stents. J Endourol 18:891–896. [PubMed][CrossRef]
56. Akay AF, Aflay U, Gedik A, Sahin H, Birean MK. 2007. Risk factors for lower urinary tract infection and bacterial stent colonization in patients with a double J ureteral stent. Int Urol Nephrol 39:95–90. [PubMed][CrossRef]
57. Wullt B, Agace W, Mansson W. 2004. Bladder bowel and bugs–bacteriuria in patients with intestinal urinary diversion. World J Urol 22:186–195. [PubMed][CrossRef]
58. Suriano F, Gallucci M, Flammia P, Musco S, Alcini A, Imbalzanot G, Dicuonzo G. 2007. Bacteriuria in patients with an orthoptic ileal neobladder: urinary tract infection or asymptomatic bacteriuria? Brit J Urol Internat 101:1576–1579. [PubMed][CrossRef]
59. Wood DP, Bianco FJ Jr, Pontes JE, Heath MA, daJusta D. 2003. Incidence and significance of positive urine cultures in patients with an orthoptic neobladder. J Urol 169:2196–2199. [PubMed][CrossRef]
60. Elder HA, Santamarina BAG, Smith S, Kass EH. 1971. The natural history of asymptomatic bacteriuria during pregnancy. Am J Obstet Gynecol 111:441–462. [PubMed]
61. Breitenbucher RB. 1984. Bacterial changes in the urine samples of patients with long term indwelling catheters. Arch Intern Med 144:1585–1588. [PubMed][CrossRef]
62. Esclarin de Rus A, Leoni EG, Cabrera RH. 2000. Epidemiology and risk factors for urinary tract infection in patients with spinal cord injury. J Urol 164:1285–1289. [PubMed][CrossRef]
63. Abrutyn E, Mossey J, Levison M, Boscia J, Pitsakis P, Kaye D. 1991. Epidemiology of asymptomatic bacteriuria in elderly women. J Am Ger Soc 39:388–393. [PubMed][CrossRef]
64. Monane M, Gurwitz JH, Lipsitz LA, Glynn RJ, Choodnovskiy I, Avorn J. 1995. Epidemiology and diagnostic aspects of bacteriuria: a longitudinal study in older women. J Am Ger Soc 43:618–622. [PubMed][CrossRef]
65. Kasviki-Charvati P, Drolette-Kefakis B, Papanayiotou PC, Dontas AS. 1982. Turnover of bacteriuria in old age. Age Aging 11:169–174. [PubMed][CrossRef]
66. Lincoln K, Winberg J. 1964. Studies of urinary tract infection in infancy and childhood II. Quantitative estimation of bacteriuria in unselected neonates with special reference to the occurrence of asymptomatic infections. Acta Paediat 53:307–316. [PubMed][CrossRef]
67. Silverberg DS, Allard MJ, Ulan RA, Beamish WE, Lentle BC, McPhee MS, Grace MG. 1973. City-wide screening for urinary abnormalities in schoolgirls. Can Med Assoc J 109:981–985. [PubMed]
68. Bengtsson C, Bengtsson U, Bjorkelund C, Lincoln K, Sigurdsson JA. 1998. Bacteriuria in a population sample of women: 24 year follow-up study. Scand J Urol Nephrol 32:284–289. [PubMed][CrossRef]
69. Tencer J. 1988. Asymptomatic bacteriuria–a long-term study. Scand J Urol Nephrol 22:31–34. [PubMed]
70. Wullt B, Bergsten G, Fischer H, Godaly G, Karpman D, Leijonhufuud I, Lundstedt A-C, Samuelsson P, Samuelsson M, Svensson M-L, Svanborg C. 2003. The host response to urinary tract infection. Infect Dis Clin N Am 17:279–301. [PubMed][CrossRef]
71. Hextall A, Hooper R, Cardozo L, Stringer C, Workman R. 2004. Dose the menopause influence the risk of bacteriuria? Int Urogynecol J 12:332–336. [PubMed][CrossRef]
72. Pabich WL, Fihn SD, Stamm WE, Scholes D, Boyko EJ, Gupta K. 2003. Prevalence and determinants of vaginal flora alterations in postmenopausal women. J Infect Dis 188:1054–1058. [PubMed][CrossRef]
73. Barabas G, Molstad S. 2005. No association between elevated post-void residual volume and bacteriuria in residents of nursing homes. Scand J Primary Health Care 23:52–56. [PubMed][CrossRef]
74. Ouslander JG, Greengold B, Chen S. 1987. External catheter use and urinary tract infections among incontinent male nursing-home patients. J Am Ger Soc 35:1063–1070. [PubMed][CrossRef]
75. Geerlings SE. 2008. Urinary tract infections in patients with diabetes mellitus: epidemiology, pathogenesis and treatment. Internat J Antimicrob Agents 31:S54–S57. [PubMed][CrossRef]
76. Hampson SJ, Nobel JG, Rickards D, Milroy EJG. 1992. Does residual urine predispose to urinary tract infection? Brit J Urol 70:506–508. [PubMed]
77. Sorto R, Irizar SS, Delgadillo G, Alberu J, Correa-Rotter R, Morales-Buenrostro LE. 2010. Risk factors for urinary tract infections during the first year after kidney transplantation. Transplant Proceedings 42:280–281. [PubMed][CrossRef]
78. Mabbett AN, Ulett GC, Watts RE, Tree JJ, Totsika M, Ong CLY, Wood JM, Monaghan W, Looke DF, Nimmo GR, Svanborg C, Schembri MA. 2009. Virulence properties of asymptomatic bacteriuric Escherichia coli. Int J Med Microbiol 299:53–63. [PubMed][CrossRef]
79. Stenqvist K, Sandberg T, Lidin-Janson G, Orskov F, Orskov I, Svanborg-Eden C. 1987. Virulence factors of Escherichia coli in urinary isolates from pregnant women. J Infect Dis 156:870–877. [PubMed][CrossRef]
80. Geerlings SE, Brouwer EC, Gaastra W, Stolk R, Diepersloot RJ, Hoepelman AI. 2001. Virulence factors of Escherichia coli isolated from urine of diabetic women with asymptomatic bacteriuria: correlation with clinical characteristics. Antonie Van Leeuwenhoek 80:119–127. [PubMed][CrossRef]
81. Dalal S, Nicolle L, Marrs CF, Zhang L, Harding G, Foxman B. 2009. Long-term Escherichia coli asymptomatic bacteriuria among women with diabetes mellitus. Clin Infect Dis 49:491–497. [PubMed][CrossRef]
82. Brauner A, Flodin U, Hylander B, Ostenson C-G. 1993. Bacteriuria, bacterial virulence and host factors in diabetic patients. Diabetic Med 10:550–554. [PubMed][CrossRef]
83. Benton J, Chawa J, Parry S, Stickler D. 1992. Virulence factors in Escherichia coli from urinary tract infections in patients with spinal injuries. J Hosp Infect 22:117–127. [PubMed][CrossRef]
84. Abraham S, Chapman TA, Zhang R, Chin J, Mabbett AN, Totsika M, Schembri MA. 2012. Molecular characterization of Escherichia coli strains that cause symptomatic and asymptomatic urinary tract infections. J Clin Microbiol 50:1027–1030. [PubMed][CrossRef]
85. Klemm P, Roos V, Ulett GC, Svanborg C, Schembri MA. 2006. Molecular characterization of the Escherichia coli asymptomatic bacteriuria strain 83972: the taming of a pathogen. Infect Immun 74:781–785. [PubMed][CrossRef]
86. Roos V, Schembri MA, Ulett GC, Klemm P. 2006. Asymptomatic bacteriuria Escherichia coli strain 83972 carries mutations in the foc locus and is unable to express F1C fimbrae. Microbiology 152:1799–1806. [PubMed][CrossRef]
87. Watts RE, Hancock V, Ong C-LY, Vejborg RM, Mabbett AN, Totsika M, Looke DF, Nimmo GR, Klemm P, Schembri MA. 2010. Escherichia coli isolates causing asymptomatic bacteriuria in catheterized and non-catheterized individuals possess similar virulence properties. J Clin Microbiol 48:2449–2458. [PubMed][CrossRef]
88. Sahl JW, Lloyd AL, Redman JC, Cebula TA, Wood DP, Mobley HLT, Rasko DA. 2011. Genomic characterization of asymptomatic E. coli isolated from the neobladder. Microbiology 157:1088–1102. [PubMed][CrossRef]
89. Podsehun R, Sievers D, Fischer A, Ullmann U. 1993. Serotypes, hemagglutinins, siderophore synthesis and serum resistance of Klebsiella isolates causing human urinary tract infections. J Infect Dis 168:1415–1421. [PubMed][CrossRef]
90. Mobley HL, Chippendale GR, Tenney JH, Mayrer AR, Crips LJ, Penner JL, Warren JW. 1988. MR/K hemagglutination of Providencia stuartii correlates with adherence to catheters and with persistence in catheter-associated bacteriuria. J Infect Dis 157:264–271. [PubMed][CrossRef]
91. Mobley HL, Warren JW. 1987. Urease-positive bacteriuria and obstruction of long term urinary catheters. J Clin Microbiol 25:2216–2217. [PubMed]
92. Warren JW, Tenney JH, Hoopes JM, Muncie HL, Anthony WC. 1982. A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters. J Infect Dis 146:719–723. [PubMed][CrossRef]
93. Wettergren B, Hellstrom M, Stokland E, Jodal U. 1990. Six year follow-up of infants with bacteriuria on screening. BMJ 301:845–848. [PubMed][CrossRef]
94. Linderg U. 1975. Asymptomatic bacteriuria in school girls. The clinical course and response to treatment. Acta Peadiatr Scand 64:718–724. [PubMed][CrossRef]
95. Hansson S, Caugant D, Jodal U, Svanborg-Eden C. 1989. Untreated asymptomatic bacteriuria in girls. I–Stability of urinary isolates. BMJ 298:853–855. [PubMed][CrossRef]
96. Kunin CM. 1970. The natural history of recurrent bacteriuria in school-aged girls. N Engl J Med 282:1443–1448. [PubMed][CrossRef]
97. Asscher AW, Sussman M, Waters WE, Evans JAS, Campbell H, Evans KT, Williams JE. 1969. Asymptomatic significant bacteriuria in the non-pregnant women II. Response to treatment and follow-up. BMJ 1:804–806. [PubMed][CrossRef]
98. Asscher AW, Sussman M, Waters WE, Evans JAS, Campbell H, Evans KT, Williams JE. 1969. The clinical significant of asymptomatic bacteriuria in the nonpregnant woman. J Infect Dis 120:17–26. [PubMed][CrossRef]
99. Raz R, Sakran W, Chazan B, Kunin C. 2003. Long-term follow-up of women hospitalized for acute pyelonephritis. Clin Infect Dis 37:1014–1020. [PubMed][CrossRef]
100. Nicolle LE, Zhanel GG, Harding GKM. 2006. Microbiology outcomes in women with diabetes and untreated asymptomatic bacteriuria. World J Urol 24:61–65. [PubMed][CrossRef]
101. Nordenstam G, Sundh, Lincoln K, Svanborg A, Svanborg Eden C. 1989. Bacteriuria in representative population samples of persons aged 72–79 years. Amer J Epidemiol 130:1176–1186. [PubMed]
102. Mims AD, Norman DC, Yamamura RH, Yoshikawa TT. 1990. Clinically inapparent (asymptomatic) bacteriuria in ambulatory elderly men: epidemiological, clinical, and microbiological findings. J Am Ger Soc 38:1209–1214. [CrossRef]
103. LiPuma JJ, Stull TL, Dason SE, Pidcock KA, Kaye D, Korzeniowski OM. 1989. DNA polymorphisms among Escherichia coli isolated from bacteriuric women. J Infect Dis 159:526–532. [PubMed][CrossRef]
104. Elden H, Hizmetli S, Nacitarhan V, Kunt B, Goker I. 1997. Relapsing significant bacteriuria: effect on urinary tract infection in patients with spinal cord injury. Arch Phys Med Rehabil 78:468–470. [PubMed][CrossRef]
105. Siegel SR, Siegel B, Sokoloff BZ, Kanter MH. 1980. Urinary infection in infants and preschool children. Five year follow-up. Am J Dis Child 134:369–372. [PubMed][CrossRef]
106. Lindberg U, Claesson I, Hanson LA, Jodal U. 1976. Asymptomatic bacteriuria in school-aged girls. Clinical and laboratory findings. Acta Paediatr Scand 64:425–431. [PubMed][CrossRef]
107. Lindberg U, Claesson I, Hanson LA, Jodal U. 1978. Asymptomatic bacteriuria in school-aged girls VIII: Clinical course during a 3-year follow-up. J Pediatr 92:194–199. [CrossRef]
108. Hansson S, Jodal U, Lincoln K, Svanborg Eden C. 1989. Untreated asymptomatic bacteriuria in girls: II Effect of phenoxymethylpenicillin and erythromycin given for intercurrent infections. BMJ 298:856–859. [PubMed][CrossRef]
109. Gillenwater JY, Harrison RB, Kunin CM. 1979. Natural history of bacteriuria in school-aged girls: A long-term case-control study. N Engl J Med 301:396–399. [PubMed][CrossRef]
110. Switzer S. 1961. Bacteriuria in a healthy population and its relation to hypertension and pyelonephritis. N Engl J Med 264:7–10. [PubMed][CrossRef]
111. Miall WE, Kass EH, Ling J, Stuart KL. 1962. Factors influencing arterial pressure in the general population in Jamaica. BMJ ii:497–506. [PubMed][CrossRef]
112. Evans DA, Kass EH, Hennekens CH, Rosner B, Miao L, Kendrick MI, Miall WE, Stuart KL. 1982. Bacteriuria and subsequent mortality in women. Lancet i:156–158. [PubMed][CrossRef]
113. Foxman B, Somsel P, Tallman P, Gillespie B, Raz R, Colodner R, Kandula D, Sobel JD. 2001. Urinary tract infection among women aged 40 to 65: behavioral and sexual risk factors. J Clin Epidemiol 54:710–718. [PubMed][CrossRef]
114. Smith HS, Hughes JP, Hooton TM, Roberts P, Scholes D, Stergachis A, Stapleton A, Stamm WE. 1997. Antecedent antimicrobial use increases the risk of uncomplicated cystitis in young women. Clin Infect Dis 25:63–68. [PubMed][CrossRef]
115. Geerlings SE, Stolk RP, Camps MJ, Netten PM, Collet JT, Schneeberger PM, Hoepelman AI. 2001. Consequences of asymptomatic bacteriuria in women with diabetes mellitus. Arch Int Med 161:1421–1427. [PubMed][CrossRef]
116. Melland R, Geerlings SE, Stolk RP, Netten PM, Schneeberger PM, Hoepelman AI. 2006. Asymptomatic bacteriuria in women with diabetes mellitus: effect on renal function after 6 years of follow-up. Arch Intern Med 166:2222–2227. [PubMed][CrossRef]
117. Brumfitt W. 1976. The effects of bacteriuria in pregnancy on maternal and fetal health. Kidney Int Suppl 8:S113–S119. [PubMed]
118. Romero R, Oyarzun E, Mazor M, Sirtori M, Hobbins JC, Bracken M. 1989. Meta-analysis of the relationship between asymptomatic bacteriuria and pre-term delivery/low birth weight. Obstet Gynecol 73:576–582. [PubMed]
119. Patterson TF, Andriole VT. 1997. Detection, significance, and therapy of bacteriuria in pregnancy. Infect Dis Clin N Amer 11:593–608. [PubMed][CrossRef]
120. Boscia JA, Kobasa WD, Abrutyn E, Levison ME, Kaplan AM, Kaye D. 1986. Lack of association between bacteriuria and symptoms in the elderly. Am J Med 81:979–982. [PubMed][CrossRef]
121. Das R, Towle V, Van Ness PH, Juthani-Mehta M. 2011. Adverse outcomes in nursing home residents with increased episodes of observed bacteriuria. Infect Control Hosp Epidemiol 32:84–86. [PubMed][CrossRef]
122. Prio TK, Bruunsgaard H, Roge B, Pederson BK. 2002. Asymptomatic bacteriuria in elderly humans is associated with increased levels of circulatory TNF receptors and elevated numbers of neutrophils. Exper Geront 37:693–699. [PubMed][CrossRef]
123. Nicolle LE, Brunka J, McIntyre M, Murray P, Harding GKM. 1992. Asymptomatic bacteriuria, urinary antibody and survival in the institutionalized elderly. J Am Ger Soc 40:607–613. [PubMed][CrossRef]
124. Loeb M, Bentley DW, Bradley S, Crosley K, Garibaldi R, Gantz N, McGeer A, Muder RR, Mylotte J, Nicolle LE, Nurse B, Paton S, Simor AE, Smith P, Strausbaugh L. 2001. Development of minimum criteria for the initiation of antibiotics in residents of long term care facilities: results of a consensus conference. Infect Control Hosp Epidemiol 22:120–124. [PubMed][CrossRef]
125. Nicolle LE. Urinary tract infection in long-term care facility residents. 2000. Clin Infect Dis 31:757–761. [PubMed][CrossRef]
126. Loeb M, Brazil K, Lohfeld L, McGeer A, Simor A, Stevenson K, Zoutman D, Smith S, Liu X, Walter SD. 2005. Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: cluster randomized controlled trial. BMJ 33:669. [PubMed][CrossRef]
127. Orr P, Nicolle LE, Duckworth H, Brunka J, Kennedy J, Murray D, Harding GKM. 1996. Febrile urinary infection in the institutionalized elderly. Amer J Med 100:71–77. [CrossRef]
128. Sourander LB, Kasanen A. 1972. A 5 year follow-up of bacteriuria in the aged. Geront Clin 14:274–281. [PubMed][CrossRef]
129. Dontas AS, Kasvik-Charvati P, Papanayiotou PC, Marketos SG. 1981. Bacteriuria and survival in old age. N Engl J Med 304:939–948. [PubMed][CrossRef]
130. Heinamaki P, Haavesto M, Hakulinem T, Mattila K, Rajola S. 1986. Mortality in relation to urinary characteristics in the very aged. Gerontology 32:167–171. [PubMed][CrossRef]
131. Nordenstam GR, Bradber CA, Oden AS, Svanborg-Eden CM, Svanborg A. 1986. Bacteriuria and mortality in an elderly population. N Eng J Med 314:1152–1156. [PubMed][CrossRef]
132. Abrutyn E, Mossey J, Berlin JA, Boscia J, Levison M, Pitsakis P, Kaye D. 1994. Does asymptomatic bacteriuria predict mortality and does antimicrobial treatment reduce mortality in elderly and ambulatory women? Ann Intern Med 120:827–833. [PubMed][CrossRef]
133. Nicolle LE, Henderosn E, Bjornson J, McIntyre M, Harding GK, MacDonell JA. 1987. The association of bacteriuria with resident characteristics and survival in elderly institutionalized men. Ann Intern Med 106:682–686. [PubMed][CrossRef]
134. High K, Bradley S, Loeb M, Palmer R, Quagliarello V, Yoshikawa T. 2005. A new paradigm for clinical investigation of infectious syndromes in older adults: assessing functional status as a risk factor and outcome measure. Clin Infect Dis 40:114–122. [PubMed][CrossRef]
135. Tambyah PA, Maki DG. 2000. Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1,497 catheterized patients. Arch Intern Med 160:678–682. [PubMed][CrossRef]
136. Srinivasan A, Karchmer T, Richards A, Song X, Perl TM. 2006. A prospective trial of a novel, silicone-coated, silver-coated Foley catheter for the prevention of nosocomial urinary tract infection. Infect Control Hosp Epidemiol 27:38–43. [PubMed][CrossRef]
137. Platt R, Polk BF, Murdock B, Rosner B. 1982. Mortality associated with nosocomial urinary tract infection. N Engl J Med 307:637–642. [PubMed][CrossRef]
138. Nicolle LE. 2012. Urinary catheter-associated infections. Infect Dis Clin N Am 26:13–27. [PubMed][CrossRef]
139. Warren JW, Damron D, Tenney JH, Hoopes JM, Deforge B, Muncie HL Jr. 1987. Fever, bacteremia, and death as complications of bacteriuria in women with long term urethral catheters. J Infect Dis 155:1151–1158. [PubMed][CrossRef]
140. Muder RR, Brennen C, Wagener MM, Goetz AM. 1992. Bacteremia in a long term care facility: a five year prospective study of 163 consecutive episodes. Clin Infect Dis 14:647–654. [PubMed][CrossRef]
141. Rudman D, Hontanosas A, Cohen Z, Mattson DE. 1998. Clinical correlates of bacteremia in a veteran’s administration extended care facility. J Am Geriatr Soc 36:726–732. [PubMed][CrossRef]
142. Bregenzer T, Frei R, Widmer AF, Seiler W, Probst W, Mattarelli G, Zimmerli W. 1997. Low risk of bacteremia during catheter replacement in patients with long-term urinary catheters. Arch Intern Med 157:521–525. [PubMed][CrossRef]
143. Jewes LA, Gillespie WA, Leadbetter A, Myers B, Simpson RA, Stower MJ, Viant AC. 1988. Bacteriuria and bacteremia in patients with long-term indwelling catheters–a domiciliary study. J Med Microbiol 26:61–65. [PubMed][CrossRef]
144. Polastri F, Auckenthaler R, Loew F, Michel JP, Lew DP. 1990. Absence of significant bacteremia during urinary catheter manipulation in patients with chronic indwelling catheters. J Am Geriatr Soc 38:1203–1208. [PubMed][CrossRef]
145. Schlager T, Dilks S, Trudell J, Whittam TS, Hendley O. 1995. Bacteriuria in children with neurogenic bladder treated with intermittent catheterization: natural history. J Pediatr 126:490–496. [CrossRef]
146. Garouiche RD, Cadle RM, Zenon GJ, Markowski J, Rodriguez M, Musher DM. 1993. Progression from asymptomatic to symptomatic urinary tract infection in patients with SCI: A preliminary study. J Am Paraplegia Soc 16:219–224. [PubMed]
147. Grabe M. 1987. Antimicrobial agents in transurethral prostatic resection. J Urol 138:245–252. [PubMed]
148. Grabe M. 2011. Antibiotic prophylaxis in urological surgery; a European viewpoint. Int J Antimicrob Agents 385:58–63. [PubMed][CrossRef]
149. Alangaden GJ. 2007. Urinary tract infections in renal transplant recipients. Curr Infect Dis Rep 9:475–479. [PubMed][CrossRef]
150. Gurwith MJ, Brunton JL, Lank BA, Harding GK, Ronald AR. 1979. A prospective controlled investigation of prophylactic trimethoprim/sulfamethoxazole in hospitalized granulocytopenic patients. Am J Med 66:248–256. [PubMed][CrossRef]
151. Akerlund S, Campanello M, Kaijser B, Jonsson O. 1994. Bacteriuria in patients with a continent ileal reservoir for urinary diversion does not regularly require antibiotic treatment. Brit J Urol 74:177–181. [PubMed][CrossRef]
152. Lee S-F, Kim K-T, Park Y-S, Kim Y-B. 2010. Association between asymptomatic urinary tract infection and postoperative spine infection in elderly women: A retrospective analysis study. J Korean Neurosurg Soc 47:265–270. [PubMed][CrossRef]
153. Glynn MK, Sheehan JM. 1984. The significance of asymptomatic bacteriuria in patients undergoing hip/knee arthroplasty. Clin Ortho Relat Res 185:151–154. [PubMed][CrossRef]
154. Ritter MA, Fechtman RW. 1987. Urinary tract sequelae: Possible influence on joint infections following total joint replacement. Orthopedics 10:467–469. [PubMed]
155. Savage CDL, Howie G, Adler K, Wilson MI. 1976. Controlled trial of therapy in covert bacteriuria of childhood. Lancet I:358–361. [PubMed]
156. Kemper KJ, Avner ED. 1992. The case against screening urinalysis for asymptomatic bacteriuria in children. Am J Dis Chil 146:343–346. [PubMed]
157. McNair RD, MacDonald SR, Dooley SL, Peterson LR. 2000. Evaluation of the centrifuged and Gram-stained smear, urinalysis, and reagent strip testing to detect asymptomatic bacteriuria in obstetric patients. Am J Obstet Gynecol 182:1076–1079. [PubMed][CrossRef]
158. The US Preventive Services Task Force. 1990. Screening for asymptomatic bacteriuria, hematuria and proteinuria. Am Fam Physician 42:389–395. [PubMed]
159. Pels RJ, Bor DH, Woolhandler S, Himmelstein DU, Lawrence RS. 1989. Dipstick urinalysis screening of asymptomatic adults for urinary tract disorders II. Bacteriuria. J Am Med Assoc 262:1221–1224. [PubMed][CrossRef]
160. Loretzon S, Hovelius B, Miorner H, Tendler M, Aberg A. 1990. The diagnosis of bacteriuria during pregnancy. Scand J Prim Health Care 8:81–83. [PubMed][CrossRef]
161. LeBlanc AL, McGanity WJ. 1964. The impact of bacteriuria in pregnancy–a survey of 1300 pregnant patients. Biol Med (Paris) 22:336–347. [PubMed]
162. Uncu Y, Uncu G, Esmer A, Bilgel N. 2002. Should asymptomatic bacteriuria be screened in pregnancy? Clin Exp Obstet Gynecol 29:281–285. [PubMed]
163. Widmer M, Gulmezoglu AM, Mignini L, Roganti A. 2011. Duration of treatment for asymptomatic bacteriuria during pregnancy. Cochrane Database Syst Rev Issue 12, Art No CD000491. [PubMed][CrossRef]
164. Lumbiganon P, Villar J, Laopaiboon M, Widmer M, Thinkhamrop J, Carroli G, Vy ND, Mignini L, Feston M, Prasertcharoensak W, Limpongsanurak S, Liabsuetrakul T, Sirivatanapa P. 2009. One day compared with 7-day nitrofurantoin for asymptomatic bacteriuria in pregnancy. Obstet Gynecol 113:339–345. [PubMed][CrossRef]
165. Whalley PJ, Cunningham FG. 1977. Short-term versus continuous antimicrobial therapy for asymptomatic bacteriuria in pregnancy. Obstet Gynecol 49:262–265. [PubMed]
166. ACOG Committee on Obstetric Practice. 2002. Obstetric management of patients with spinal cord injuries. Obstet Gynecol 100:625–627. [PubMed][CrossRef]
167. Semetkowska-Jurkiewicz E, Horoszek-Maziarz S, Galinski J, Manitius A, Krupa-Wojciechowska B. 1995. The clinical course of untreated asymptomatic bacteriuria in diabetic patients–14 year follow-up. Mater Med Pol 27:91–95. [PubMed]
168. Ouslander JG, Schapira M, Schnelle JF, Uman G, Finegold S, Tuico E, Nigom JG. 1995. Does eradicating bacteriuria affect the severity of chronic urinary incontinence in nursing home residents? Ann Intern Med 122:749–754. [PubMed][CrossRef]
169. Boscia JA, Kobasa WD, Knight RA, Abrutyn E, Levison ME, Kaye D. 1987. Therapy vs no therapy for bacteriuria in elderly, ambulatory, non-hospitalized women. JAMA 257:1067–1071. [PubMed][CrossRef]
170. Hustinx WNM, Mintjes-de Groot AJ, Verkooyen RP, Verbrugh HA. 1991. Impact of concurrent antimicrobial therapy on catheter-associated urinary tract infection. J Hosp Infect 18:45–56. [PubMed][CrossRef]
171. Warren JW, Platt R, Thomas RJ, Rosner B, Kass EH. 1979. Antibiotic irrigation and catheter-associated urinary tract infections. N Engl J Med 299:570–573. [PubMed][CrossRef]
172. Leone M, Perrin A-S, Granier I, Visintini P, Blasco V, Antonini F, Albanese J, Martin C. 2007. A randomized trial of catheter change and short course antibiotics for asymptomatic bacteriuria in catheterized ICU patients. Intensive Care Med 33(4):726–729. [PubMed][CrossRef]
173. Pfefferkorn U, Lea S, Moldenhauer J, Peterli R, von Flue M, Ackermann C. 2009. Antibiotic prophylaxis at urinary catheter removal prevents urinary tract infections: a prospective randomized trial. Ann Surg 249:573–575. [PubMed][CrossRef]
174. van Hees BG, Vijverberg PL, Hoorntie LE, Wiltink EH, Go PM, Tersmette M. 2011. Single dose oral antibiotic prophylaxis for urinary catheter removal does not reduce the risk of urinary tract infection in surgical patients: a randomized double blind placebo-controlled trial. Clin Microbiol Infect 17:1091–1094. [PubMed][CrossRef]
175. Wazait HD, Patel HR, van der Meulen JH, Ghei M, Al-Buheissi S, Kelsey M, Miller RA, Emberton M. 2004. A pilot randomized double-blind placebo-controlled trial on the use of antibiotics on urinary catheter removal to reduce the rate of urinary tract infection: the pitfalls of ciprofloxacin. Brit J Urol 94:1048–1050. [PubMed][CrossRef]
176. Harding GK, Nicolle LE, Ronald AR, Preiksaitis JK, Forward KR, Cheang M. 1991. Management of catheter-acquired urinary tract infection in women: Therapy following catheter removal. Ann Intern Med 114:713–719. [PubMed][CrossRef]
177. Warren JW, Anthony WC, Hoopes JM, Muncie HL Jr. 1982. Cephelexin for susceptible bacteriuria in afebrile long-term catheterized patients. JAMA 248:454–458. [PubMed][CrossRef]
178. Alling B, Brandberg A, Secberg S, Svanborg A. 1975. Effect of consecutive antibacterial therapy on bacteriuria in hospitalized geriatric patients. Scand J Infect Dis 7:201–209. [PubMed][CrossRef]
179. Waites KB, Canapp KC, Roper JF, Camp SM, Chen Y. 2006. Evaluation of 3 methods of bladder irrigation to treat bacteriuria in persons with neurogenic bladder. J Spinal Cord Med 29:217–226. [PubMed]
180. Gribble MJ, Puterman ML. 1993. Prophylaxis of urinary tract infection in persons with recent spinal cord injury: A prospective, randomized double-blind, placebo controlled study of trimethoprim/sulfamethoxazole. Am J Med 95:141–152. [CrossRef]
181. Waites KB, Canupp KC, DeVivo MJ. 1993. Eradication of urinary tract infection following spinal cord injury. Paraplegia 31:654–652. [PubMed][CrossRef]
182. Mohler JL, Cowen DL, Flanigan RC. 1987. Suppression and treatment of urinary tract infection in patients with an intermittently catheterized neurogenic bladder. J Urol 138:336–340. [PubMed]
183. National Institute on Disability and Rehabilitation Research Consensus Statement. 1992. The prevention and management of urinary tract infections among people with spinal cord injuries. J Am Paraplegia Soc 15:194–204. [PubMed]
184. Grabe M, Forsgren A, Bjork T, Hellsten S. 1987. Controlled trial of a short and a prolonged course with ciprofloxacin in transurethral prostatic surgery. Eur J Clin Microbiol 6:11–17. [PubMed][CrossRef]
185. Grabe M, Forsgren A, Hellsten S. 1984. The effect of a short antibiotic course in transurethral prostatic resection. Scand J Urol Nephrol 18:37–42. [PubMed][CrossRef]
186. Allen WR, Kumar A. 1985. Prophylactic mezlocillin for transurethral prostatectomy. Brit J Urol 57:46–49. [PubMed][CrossRef]
187. Olsen JH, Friis-Moller A, Jensen SK, Korner B, Hvidt V. 1983. Cefotaxime for prevention of infection complications in bacteriuric men undergoing transurethral prostatic resection: a controlled comparison with methenamine. Scand J Urol Nephrol 17:299–301. [PubMed][CrossRef]
188. Cafferkey MT, Falkiner FR, Gillespie WA, Murphy DM. 1982. Antibiotics for the prevention of septicemia in urology. J Antimicrob Chemother 9:471–477. [PubMed][CrossRef]
189. Naber KG, Bergman B, Bishop MC, Bjerklund-Johnsen TE, Botto H, Lobel B, Cruz FJ, Selvaggi FP. 2001. EAU guidelines for the management of urinary and male genital tract infections. Eur Urol 40:576–588. [PubMed][CrossRef]
190. El Amari EB, Hadaya K, Buhler L, Berney T, Rohner P, Martin PY, Mentha G, van Delden C. 2011. Outcome of treated and untreated asymptomatic bacteriuria in renal transplant recipients. Nephrol Dial Transplant 26:4109–4114. [PubMed][CrossRef]
191. Fakas N, Souli M, Koratzanis G, Karageorgiou C, Giamarellou H, Kanellakopoulou K. 2010. Effects of antimicrobial prophylaxis on asymptomatic bacteriuria and predictors of failure in patients with multiple sclerosis. J Chemother 22:36–42. [PubMed][CrossRef]
192. Sobel JD, Kauffman CA, McKinsey D, Zervos M, Vazquez JA, Karchmer AW, Lee J, Thomas C, Panzer H, Dismukes WE. 2000. Candiduria a randomized double-blind study of treatment with fluconazole and placebo. Clin Infect Dis 30:19–24. [PubMed][CrossRef]
193. Reid G, Howard J, Gan BS. 2001. Can bacterial interference prevent infection? Trends Microbiol 9:424–428. [PubMed][CrossRef]
194. Hull RA, Rudy DC, Donovan WH, Wieser IE, Stewart C, Darouiche RO. 1999. Virulence properties of Escherichia coli 83972, a prototype strain associated with asymptomatic bacteriuria. Infect Immun 67:429–432. [PubMed]
195. Anderson P, Engberg I, Lidin-Janson G, Lincoln K, Hull R, Hull S, Svanborg C. 1991. Persistence of Escherichia coli bacteriuria is not determined by bacterial adherence. Infect Immun 2915–2921.
196. Darouiche RO, Green BG, Donovan WH, Chen D, Schwartz M, Merritt J, Mendez M, Hull RA. 2011. Multicentre randomized controlled trial of bacterial interference for prevention of urinary tract infection in patients with neurogenic bladder. Urology 78:341–347. [PubMed][CrossRef]
197. Trautner BW, Hull RA, Thornby JI, Darouiche RO. 2007. Coating urinary catheters with an avirulent strain of Escherichia coli as a mean to establish asymptomatic colonization. Infect Control Hosp Epidemiol 28:92–94. [PubMed][CrossRef]
198. Wullt B, Connell H, Rollano P, Mansson W, Colleen S, Svanborg C. 1998. Urodynamic factors influence the duration of Escherichia coli in deliberately colonized cases. J Urol 159:2057–2062. [PubMed][CrossRef]
199. Hull R, Rudy D, Donovan W, Svanborg C, Wieser I, Stewart C, Darouchie R. 2000. Urinary tract infection prophylaxis using Escherichia coli 83972 in spinal cord injured patients. J Urol 163:872–877. [PubMed][CrossRef]
200. Sunden F, Hakansson L, Ljunggren E, Wullt B. 2006. Bacterial interference–is deliberate colonization with Escherichia coli 83972 an alternative treatment for patients with recurrent urinary tract infection? Int J Antimicrob Agents 28(Suppl 1):S26–S29. [PubMed][CrossRef]
201. Darouiche RO, Thorby JI, Cerra-Stewart C, Donovan WH, Hull RA. 2005. Bacterial interference for prevention of urinary tract infection: A prospective, randomized, placebo-controlled, double-blind pilot trial. Clin Infect Dis 41:1531–1534. [PubMed][CrossRef]
202. Sunden F, Hakansson L, Ljunggren E, Wullt B. 2010. Escherichia coli 83972 bacteriuria protects against recurrent lower urinary tract infections in patients with incomplete bladder emptying. J Urol 184:179–185. [PubMed][CrossRef]
203. Zdziarski J, Svanborg C, Wullt B, Hacker J, Dobrindt U. 2008. Molecular bases of commensalism in the urinary tract; low virulence or virulence attenuation? Infect Immun 76:695–703. [PubMed][CrossRef]
204. Lipsky B. 1989. Urinary tract infections in men: Epidemiology, pathophysiology, diagnosis, and treatment. Ann Intern Med 110:138–150. [PubMed][CrossRef]
205. Silverberg DS, Jackson FL, Bryan LE. 1976. Antibody-coated bacteria in the urine of preschool and school-aged girls with asymptomatic bacteriuria. Can Med Assoc J 15:1091–1093.
206. Rogers K, Nicolle LE, McIntyre M, Harding GKM, Hoban D, Murray D. 1991. Pyuria in institutionalized elderly subjects. Can J Infect Dis 2:142–146. [PubMed]
207. Aguirre-Avlos G, Zavala-Silva ML, Diaz-Nava A, Amaya-Tapia G, Aguilar-Benavides S. 1999. Asymptomatic bacteriuria and inflammatory response to urinary tract infection in elderly ambulatory women in nursing homes. Arch Med Res 30:29–32. [PubMed][CrossRef]
208. Juthani-Mehta M, Tinetti M, Perrelli E, Towle V, Quagliarello V. 2007. Role of dipstick testing in the evaluation of urinary tract infection in nursing home residents. Infect Control Hosp Epidemiol 28:889–891. [PubMed][CrossRef]
209. Gribble MJ, Puterman ML, McCallum MN. 1989. Pyuria: Its relationship to bacteriuria in spinal cord injured patients on intermittent catheterization. Arch Phys Med Rehab 70:376–379. [PubMed]
210. Randolph MF, Greenfield M. 1964. The incidence of asymptomatic bacteriuria and pyuria in infancy: A study of 400 infants in private practice. J Pediatr 65:57–66. [PubMed][CrossRef]
211. Jackson SL, Boyko EJ, Scholes D, Abraham L, Gupta K, Fihn SD. 2004. Predictors of urinary tract infection after menopause: A prospective study. Am J Med 117:903–911. [PubMed][CrossRef]
212. Lee BB, Haran MJ, Hunt LM, Simpson JM, Marial OK, Rutkowski SB, Middleton JW, Kotsiou G, Tudehope M, Cameron ID. 2007. Spinal-injured neuropathic bladder antisepsis trial. Spinal Cord 45:542–550. [PubMed][CrossRef]
213. Sanderson PJ, Weissler S. 1990. A comparison of the effect of chlorhexidine antisepsis, soap and antibiotics on bacteriuria, perineal colonization and environmental contamination in spinally injured patients. J Hosp Infect 15:235–243. [PubMed][CrossRef]
214. Boyko EJ, Fihn SD, Scholes D, Abraham L, Monsey B. 2005. Risk of urinary tract infection and asymptomatic bacteriuria among diabetic and nondiabetic postmenopausal women. Am J Epidemiol 161:557–564. [PubMed][CrossRef]
215. Saint S, Kaufman SR, Rogers MAM, Baker PD, Ossenkop K, Lipsky BA. 2006. Condom versus indwelling urinary catheters: A randomized trial. J Am Ger Soc 54:1055–1061. [PubMed][CrossRef]
216. Sandock DS, Gothe BG, Bodner DR. 1995. Trimethoprim/sulfamethoxazole prophylaxis against urinary tract infection in the chronic spinal cord injury patient. Paraplegia 32:156–160. [PubMed][CrossRef]
217. Bennett CJ, Young MN, Darrington H. 1995. Differences in urinary tract infections in male and female spinal cord injury patients on intermittent catheterization. Paraplegia 33:69–72. [PubMed][CrossRef]
218. Little PJ. 1966. The incidence of urinary infection in 5000 pregnant women. Lancet 2:925–928. [PubMed][CrossRef]
219. Kincaid-Smith P, Bullen M. 1965. Bacteriuria in pregnancy. Lancet 1:395–399. [PubMed][CrossRef]
220. Gratacos E, Torres PJ, Vila J, Alonso PL, Cararach V. 1994. Screening and treatment of asymptomatic bacteriuria in pregnancy prevent pyelonephritis. J Infect Dis 169:1390–1392. [PubMed][CrossRef]
221. Wren BG. 1969. Subclinical renal infection and prematurity. Med J Aust 2:596–600. [PubMed]
microbiolspec.UTI-0001-2012.citations
cm/3/5
content/journal/microbiolspec/10.1128/microbiolspec.UTI-0001-2012
Loading

Citations loading...

Loading

Article metrics loading...

/content/journal/microbiolspec/10.1128/microbiolspec.UTI-0001-2012
2015-09-04
2017-09-21

Abstract:

Asymptomatic bacteriuria is very common. In healthy women, asymptomatic bacteriuria increases with age, from <1% in newborns to 10% to 20% of women age 80 years, but is uncommon in men until after age 50 years. Individuals with underlying genitourinary abnormalities, including indwelling devices, may also have a high frequency of asymptomatic bacteriuria, irrespective of age or gender. The prevalence is very high in residents of long-term–care facilities, from 25% to 50% of women and 15% to 40% of men. is the most frequent organism isolated, but a wide variety of other organisms may occur. Bacteriuria may be transient or persist for a prolonged period. Pregnant women with asymptomatic bacteriuria identified in early pregnancy and who are untreated have a risk of pyelonephritis later in pregnancy of 20% to 30%. Bacteremia is frequent in bacteriuric subjects following mucosal trauma with bleeding, with 5% to 10% of patients developing severe sepsis or septic shock. These two groups with clear evidence of negative outcomes should be screened for bacteriuria and appropriately treated. Asymptomatic bacteriuria in other populations is benign and screening and treatment are not indicated. Antimicrobial treatment has no benefits but is associated with negative outcomes including reinfection with antimicrobial resistant organisms and a short-term increased frequency of symptomatic infection post-treatment. The observation of increased symptomatic infection post-treatment, however, has led to active investigation of bacterial interference as a strategy to prevent symptomatic episodes in selected high risk patients.

Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Tables

Generic image for table
TABLE 1

Quantitative urine culture criteria for diagnosis of asymptomatic bacteriuria

Source: microbiolspec September 2015 vol. 3 no. 5 doi:10.1128/microbiolspec.UTI-0001-2012
Generic image for table
TABLE 2

Prevalence of pyuria in populations with asymptomatic bacteriuria

Source: microbiolspec September 2015 vol. 3 no. 5 doi:10.1128/microbiolspec.UTI-0001-2012
Generic image for table
TABLE 3

Prevalence of asymptomatic bacteriuria in patients with a normal genitourinary tract

Source: microbiolspec September 2015 vol. 3 no. 5 doi:10.1128/microbiolspec.UTI-0001-2012
Generic image for table
TABLE 4

Prevalence of asymptomatic bacteriuria in populations with abnormalities of the genitourinary tract

Source: microbiolspec September 2015 vol. 3 no. 5 doi:10.1128/microbiolspec.UTI-0001-2012
Generic image for table
TABLE 5

Incidence of asymptomatic bacteriuria in selected populations

Source: microbiolspec September 2015 vol. 3 no. 5 doi:10.1128/microbiolspec.UTI-0001-2012
Generic image for table
TABLE 6

Studies of virulence factors in strains isolated from asymptomatic bacteriuria

Source: microbiolspec September 2015 vol. 3 no. 5 doi:10.1128/microbiolspec.UTI-0001-2012
Generic image for table
TABLE 7

Microbiology of asymptomatic bacteriuria in selected populations with complicated urinary tract infection

Source: microbiolspec September 2015 vol. 3 no. 5 doi:10.1128/microbiolspec.UTI-0001-2012
Generic image for table
TABLE 8

Asymptomatic bacteriuria in pregnancy and the frequency of pyelonephritis

Source: microbiolspec September 2015 vol. 3 no. 5 doi:10.1128/microbiolspec.UTI-0001-2012
Generic image for table
TABLE 9

Symptomatic infection in patients enrolled into prospective, randomized clinical trials of treatment or non-treatment of asymptomatic bacteriuria in populations other than pregnant women

Source: microbiolspec September 2015 vol. 3 no. 5 doi:10.1128/microbiolspec.UTI-0001-2012
Generic image for table
TABLE 10

Recommended antimicrobial regimens for the treatment of asymptomatic bacteriuria in pregnancy

Source: microbiolspec September 2015 vol. 3 no. 5 doi:10.1128/microbiolspec.UTI-0001-2012

Supplemental Material

No supplementary material available for this content.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error