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Final Recommendation Statement

Asymptomatic Bacteriuria in Adults: Screening, 2004

January 01, 2004

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.

This Recommendation is out of date

It has been replaced by the following: Asymptomatic Bacteriuria in Adults: Screening (2019)

Recommendation Summary

Population Recommendation Grade
Pregnant women The U.S. Preventive Services Task Force (USPSTF) strongly recommends that all pregnant women be screened for asymptomatic bacteriuria using urine culture at 12--16 weeks' gestation. A
Men and nonpregnant women The USPSTF recommends against the routine screening of men and nonpregnant women for asymptomatic bacteriuria. D

Recommendation Information

Table of Contents PDF Version and JAMA Link Archived Versions

Full Recommendation:

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.

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This USPSTF recommendation was first published by: Agency for Healthcare Research and Quality, Rockville, MD. February 2004.

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  • The screening tests used commonly in the primary care setting (dipstick analysis and direct microscopy) have poor positive and negative predictive value for detecting bacteriuria in asymptomatic persons. Urine culture is the gold standard for detecting asymptomatic bacteriuria but is expensive for routine screening in populations with a low prevalence of this condition. Results from one study done with a new enzymatic urine-screening test (Uriscreen™) showed that the test has a sensitivity of 100% and a specificity of 81%.
  • Good evidence exists that screening pregnant women for asymptomatic bacteriuria with urine culture (rather than urinalysis) significantly reduces symptomatic urinary tract infections, low birth weight, and preterm delivery. A specimen obtained at 12–16 weeks' gestation will detect approximately 80% of patients with asymptomatic bacteriuria. The optimal frequency of subsequent urine testing during pregnancy is uncertain.
  • Good evidence exists that screening individuals other than pregnant women for asymptomatic bacteriuria does not significantly improve clinical outcomes. Results from a study of women with diabetes who were treated for asymptomatic bacteriuria demonstrated no reduction in complications.1 Although there were short-term results in clearing bacteriuria with antimicrobial therapy, there was no decrease in the number of symptomatic episodes or hospitalizations over the long term. Furthermore, the high rate of recurrence of bacteriuria in those who were screened and treated resulted in a marked increase in the use of antimicrobial agents.
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  1. Harding GKM, Zhanel GG, Nicolle LE, Cheang M. Antimicrobial treatment in diabetic women with asymptomatic bacteriuria. N Engl J Med. 2002;347(20):1576–1583. [PubMed]
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