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Examen de detección de bacteriuria asintomática en adultos: Declaración de recomendación del grupo de trabajo de
, Douglas K Owens1,2, Karina W Davidson3
1Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
JAMA
|September 25, 2019
Resumen
La detección de bacteriuria asintomática en mujeres embarazadas mediante cultivo de orina ofrece beneficios moderados en la prevención de complicaciones perinatales. Sin embargo, no se recomienda el cribado de adultos no embarazados debido a los posibles daños que superan los beneficios.
Área de la Ciencia:
- Médico interno
- Obstetricia y Ginecología
- Enfermedades infecciosas
Sus antecedentes:
- La bacteriuria asintomática (ASB) es común, especialmente en las mujeres, y puede conducir a pielonefritis, una afección grave en el embarazo.
- La pielonefritis durante el embarazo está relacionada con resultados adversos para la madre y el feto, incluyendo septicemia y parto prematuro.
Objetivo del estudio:
- Actualizar las recomendaciones sobre el cribado y tratamiento de la bacteriuria asintomática en adultos y mujeres embarazadas.
- Evaluar los beneficios y los daños de la detección y el tratamiento de la ASB.
Principales métodos:
- El Grupo de Trabajo de Servicios Preventivos de los Estados Unidos (USPSTF) encargó una revisión sistemática de las pruebas.
- La revisión se centró en los beneficios y los daños de la detección y el tratamiento de la ASB en adultos embarazadas y no embarazadas sin síntomas de infección del tracto urinario.
Principales resultados:
- La detección y el tratamiento de ASB en mujeres embarazadas tiene un beneficio neto moderado, reduciendo las complicaciones perinatales y la incidencia de pielonefritis.
- Se encontró que los daños del tratamiento con antibióticos, incluida la alteración del microbioma, eran al menos pequeños.
- La detección y el tratamiento de ASB en adultos no embarazados no mostraron ningún beneficio neto, y los daños del tratamiento se consideraron al menos pequeños.
Conclusiones:
- El USPSTF recomienda el cribado de las mujeres embarazadas para ASB utilizando cultivos de orina (recomendación B).
- El USPSTF recomienda no hacer el cribado de adultos no embarazados para ASB (recomendación D).
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