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Asymptomatic bacteriuria

Asymptomatic bacteriuria is the occurrence of bacteria in the urine without causing symptoms.

The condition may not need treatment. This makes it different from a urinary tract infection that is caused by bacteria.

Causes

Asymptomatic bacteriuria occurs in a small number of healthy people. It affects women more often than men. The reasons for the lack of symptoms are not well understood.

Most people who have this condition do not need treatment because the bacteria are not causing any harm. People who have urinary catheters often will have bacteriuria, but most will not have symptoms.

Certain people are at a higher risk for kidney infections if they develop this problem. The following increases your risk:

  • Diabetes
  • Infected kidney stones
  • Kidney transplant
  • Older age
  • Pregnancy -- up to 40% of pregnant women with untreated asymptomatic bacteriuria will develop a kidney infection
  • Vesicoureteral reflux (backward movement of urine from the bladder into ureters or kidneys) in young children

Symptoms

Asymptomatic bacteriuria causes no symptoms. The symptoms of a urinary tract infection include burning during urination, an increased urgency to urinate, and increased frequency of urination.

Exams and Tests

A urine culture is taken from a urine sample. Asymptomatic bacteriuria is diagnosed if there is a large overgrowth of bacteria in the urine culture.

Treatment

Some people are more likely to be given antibiotics. These include pregnant women, people who have received a kidney transplant, children with vesicoureteral reflux, and those with infected kidney stones.

Giving antibiotics to persons who have long-term urinary catheters in place may cause additional problems. The bacteria may be harder to treat and a yeast infection may develop.

This condition should be treated if it is discovered before a urinary tract procedure. This may help prevent complications. The type of treatment will depend on the person's risk factors.

Possible Complications

If it is not treated, asymptomatic bacteriuria can lead to a kidney infection in people at high risk .

When to Contact a Medical Professional

Call your health care provider if you have:

  • Difficulty emptying your bladder
  • Fever
  • Flank or back pain
  • Pain with urination

You will need to be checked for a bladder or kidney infection.

References

Lin K, Fajardo K. Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2008;149:W-20-24.

Nicolle LE. Asymptomatic bacteriuria. Curr. Opin. Infect. Dis. 2014; 27(1); 90-96.

Updated: 8/17/2014

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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