The presence of bacteria in the urine does not always indicate an infection, according to a study

Physicians need to think carefully before testing patients for urinary tract infection to avoid excessive diagnosis and unnecessary antibiotic therapy, according to the updated guidelines on asymptomatic bacteriuria (ASB) published by Infectious Diseases Society of America (IDSA) and published in Clinical Infectious Diseases.

PAC – the presence of bacteria in the urine without the symptoms of an infection – are quite common and have been identified as contributing to the misuse of antibiotics, which promotes resistance. Although the updated guidelines follow previous recommendations to avoid testing certain groups of patients with no symptoms (called screening) – including non-pregnant healthy women, the elderly, diabetics and people with diabetes. spinal cord injuries – they also include groups that have not yet been addressed, such as infants and children, people who have had joint replacement or other non-urological surgery, and those who have organ transplant.

"Screening for these patients is far too common and leads to inappropriate prescribing of antibiotics, which, according to some studies, could actually increase the risk of urinary tract infection, as well as contribute to d?" other serious infections such as Clostridioides difficile, "said Lindsay E. Nicolle, MD, FIDSA, chair of the committee that developed the guidelines and professor emeritus at the Rady Faculty of Health Sciences at the University of Manitoba in Winnipeg. "As a general rule, doctors should not get urine cultures unless the patients have symptoms suggestive of an infection, such as burning during urination, frequent urination or abdominal pain, or sensitivity to the back near the ribs. "

Some symptoms that people presume indicate a urinary tract infection – such as the smell of urine and confusion in the elderly – are usually caused by other conditions that should be ruled out before the test, said Dr. Nicolle.

About 3 to 7 percent of healthy women have PAC at some point, especially those who are badually active, she said. About 50% of people with spinal injuries and 30-50% of people in nursing homes have SEBs.

The updated guidelines follow previous recommendations to screen and treat only those patients at risk of developing SEB-related complications, including pregnant women and those undergoing endoscopic urological procedures.