What is Asymptomatic Bacteriuria, and why should I care?
Bacteria live with us every day, in and around our bodies. However, there are some parts of our bodies which should be sterile, and any sign of bacteria in those places could be problematic. This includes our blood, and it also includes our urine. Skin for example, is one of those places where many bacteria reside, so when we take a urine sample it often passes through the skin catching some of those bacteria on the way. This is why a certain threshold needs to be surpassed in order to determine that there is bacteria in the urine, or bacteriuria. Asymptomatic simply means it has not yet affected our body in such a way that we can observe just yet.
Now you’re asking, why should I care. The answer to this is you shouldn’t unless you fall into one of three categories. If you are pregnant, if you are about to undergo a urological procedure (prostate for example), or if you recently received a kidney transplant. Urological procedures are often associated with bleeding, and it can be dangerous for bacteria to enter the blood stream. If you do not fall in one of those three categories, the guidelines do not recommend treatment with antibiotics.
Let’s get to the part about the pregnancy.
The first complication that we want to prevent is called pyelonephritis. This is a bacterial infection of the kidneys, and it can be potentially dangerous. It often causes a very high fever, pain in the midsection, and nausea/vomiting. It also often results in the scarring of the kidney tissue. Studies show that women who are pregnant have much higher chances of being diagnosed with pyelonephritis if they have asymptomatic bacteriuria than the general population. Taking antibiotics drastically reduces the chance of this complication.
In addition, women with untreated bacteriuria, even when asymptomatic, have much higher chances of complications with the birth. This includes giving birth early, as well as low birth weight. Treatment with antibiotics also reduced the rate of women who gave birth pre-term, as well as the number of low birth rates in effected population.
What’s the recommendation?
Women who are pregnant should be screened for asymptomatic bacteriuria ideally between 12-16 weeks of their pregnancy, though if they missed this window then they should be screened at their first prenatal visit. A simple urine test can rule out a potentially dangerous condition, and it’s very easily treatable, so don’t let this one slip though your fingers.
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Knowledge is power. It’s very important for each of us to understand what our options are, and what evidence supports each option. Preventing diseases before they start is often the most efficient way to be healthy, and this starts by screening for the diseases that are appropriate for us depending on age, gender, and other factors. Download our app to go through a short list of questions, and receive a personalized list of the appropriate screening recommendations for you. More information about each of these tests is provided through the app, so that you can stay informed and educated.
Here are a few studies which prove the efficacy of screening and early treatment for asymptomatic bacteriuria. Feel free to contact us for more information about the matter, we would be happy to provide more information.
Smaill FM, Vazquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev 2015; :CD000490.
Rouse DJ, Andrews WW, Goldenberg RL, Owen J. Screening and treatment of asymptomatic bacteriuria of pregnancy to prevent pyelonephritis: a cost-effectiveness and cost-benefit analysis. Obstet Gynecol 1995; 86:119.
American Academy of Family Physicians. Summary of recommendations for clinical preventive services. Revision 6.4. August 2007.