Clinical Summary

Asymptomatic Bacteriuria in Adults: Screening

September 24, 2019

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

What does the USPSTF recommend? For pregnant persons: Grade B
Screen persons who are pregnant for asymptomatic bacteriuria with a urine culture.
For nonpregnant adults: Grade D
Do not screen adults who are not pregnant for asymptomatic bacteriuria.
To whom does this recommendation apply? This applies to adults 18 years and older and pregnant persons of any age without signs and symptoms of a urinary tract infection.

It does not apply to persons who have chronic medical or urinary tract conditions or are hospitalized or living in institutions such as nursing homes.

What's new? This recommendation is consistent with the 2008 USPSTF recommendation. The USPSTF continues to recommend screening for pregnant persons and recommends against screening for nonpregnant adults.
How to implement this recommendation? Screen. Screen pregnant persons for asymptomatic bacteriuria using a midstream, clean-catch urine culture at the first prenatal visit or at 12 to 16 weeks of gestation, whichever is earlier. A urine culture showing >100,000 CFU/mL of a single uropathogen or >10,000 CFU/mL if the pathogen is group B streptococcus indicates treatment.
Where to read the full recommendation statement? Visit the USPSTF website to read the full recommendation statement. This includes more details on the rationale of the recommendation, including benefits and harms; supporting evidence; and recommendations of others.

The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation.