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Screening for Asymptomatic Bacteriuria in Adults: US Preventive Services Task Force Recommendation Statement.
, Douglas K Owens1,2, Karina W Davidson3
1Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
JAMA
|September 25, 2019
Summary
Screening pregnant individuals for asymptomatic bacteriuria via urine culture offers moderate benefits in preventing perinatal complications. However, screening nonpregnant adults is not recommended due to potential harms outweighing benefits.
Area of Science:
- Internal Medicine
- Obstetrics & Gynecology
- Infectious Diseases
Background:
- Asymptomatic bacteriuria (ASB) is common, particularly in women, and can lead to pyelonephritis, a serious condition in pregnancy.
- Pyelonephritis during pregnancy is linked to adverse maternal and fetal outcomes, including septicemia and preterm birth.
Purpose of the Study:
- To update recommendations on screening for and treating asymptomatic bacteriuria in adults and pregnant individuals.
- To evaluate the benefits and harms of ASB screening and treatment.
Main Methods:
- A systematic review of evidence was commissioned by the U.S. Preventive Services Task Force (USPSTF).
- The review focused on the benefits and harms of screening and treating ASB in pregnant and nonpregnant adults without urinary tract infection symptoms.
Main Results:
- Screening and treating ASB in pregnant individuals has a moderate net benefit, reducing perinatal complications and pyelonephritis incidence.
- Harms from antibiotic treatment, including microbiome alteration, were found to be at least small.
- Screening and treating ASB in nonpregnant adults showed no net benefit, with harms from treatment considered at least small.
Conclusions:
- The USPSTF recommends screening pregnant individuals for ASB using urine culture (B recommendation).
- The USPSTF recommends against screening nonpregnant adults for ASB (D recommendation).
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