Approach to a positive urine culture in a patient without urinary symptoms

Abstract

Asymptomatic bacteriuria (ASB) is a condition in which bacteria are present in a noncontaminated urine sample collected from a patient without signs or symptoms related to the urinary tract. ASB must be distinguished from symptomatic urinary tract infection (UTI) by the absence of signs and symptoms compatible with UTI or by clinical determination that a nonurinary cause accounts for the patient's symptoms. The overall purpose of this review is to promote an awareness of ASB as a distinct condition from UTI and to empower clinicians to withhold antibiotics in situations in which antimicrobial treatment of bacteriuria is not indicated.

Keywords: Antibacterial agents; Asymptomatic bacteriuria; Guidelines implementation; Urinary tract infection.

Figure 1

Validated algorithm to assist in clinical decision making about positive urine cultures in cahteterized patients. The focus of the algorithm is on reminding the clinician to stop and think about two key questions before reflexively prescribing antibiotics for bacteriuruia. Reprinted here with permission from BioMed Central.