Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine; UMass Worcester Prevention Research Center
Analytical, Diagnostic and Therapeutic Techniques and Equipment | Bacterial Infections and Mycoses | Community Health and Preventive Medicine | Health Services Administration | Preventive Medicine | Public Health Education and Promotion | Women's Health
Importance: Among the general adult population, women (across all ages) have the highest prevalence of asymptomatic bacteriuria, although rates increase with age among both men and women. Asymptomatic bacteriuria is present in an estimated 1% to 6% of premenopausal women and an estimated 2% to 10% of pregnant women and is associated with pyelonephritis, one of the most common nonobstetric reasons for hospitalization in pregnant women. Among pregnant persons, pyelonephritis is associated with perinatal complications including septicemia, respiratory distress, low birth weight, and spontaneous preterm birth.
Objective: To update its 2008 recommendation, the USPSTF commissioned a review of the evidence on potential benefits and harms of screening for and treatment of asymptomatic bacteriuria in adults, including pregnant persons.
Population: This recommendation applies to community-dwelling adults 18 years and older and pregnant persons of any age without signs and symptoms of a urinary tract infection.
Evidence Assessment: Based on a review of the evidence, the USPSTF concludes with moderate certainty that screening for and treatment of asymptomatic bacteriuria in pregnant persons has moderate net benefit in reducing perinatal complications. There is adequate evidence that pyelonephritis in pregnancy is associated with negative maternal outcomes and that treatment of screen-detected asymptomatic bacteriuria can reduce the incidence of pyelonephritis in pregnant persons. The USPSTF found adequate evidence of harms associated with treatment of asymptomatic bacteriuria (including adverse effects of antibiotic treatment and changes in the microbiome) to be at least small in magnitude. The USPSTF concludes with moderate certainty that screening for and treatment of asymptomatic bacteriuria in nonpregnant adults has no net benefit. The known harms associated with treatment include adverse effects of antibiotic use and changes to the microbiome. Based on these known harms, the USPSTF determined the overall harms to be at least small in this group.
Recommendations: The USPSTF recommends screening pregnant persons for asymptomatic bacteriuria using urine culture. (B recommendation) The USPSTF recommends against screening for asymptomatic bacteriuria in nonpregnant adults. (D recommendation).
bacteriuria, screening, pregnancy, recommendations
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DOI of Published Version
JAMA. 2019 Sep 24;322(12):1188-1194. doi: 10.1001/jama.2019.13069. Link to article on publisher's site
US Preventive Services Task Force, Owens DK, Pbert L, Wong JB. (2019). Screening for Asymptomatic Bacteriuria in Adults: US Preventive Services Task Force Recommendation Statement. UMass Worcester PRC Publications. https://doi.org/10.1001/jama.2019.13069. Retrieved from https://escholarship.umassmed.edu/prc_pubs/151
Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons, Bacterial Infections and Mycoses Commons, Community Health and Preventive Medicine Commons, Health Services Administration Commons, Preventive Medicine Commons, Public Health Education and Promotion Commons, Women's Health Commons