Asymptomatic bacteriuria in patients with diabetes mellitus
- Amy C Weintrob, MD
Amy C Weintrob, MD
- Associate Professor of Medicine
- The George Washington University and Veterans Affairs Medical Center
- Daniel J Sexton, MD
Daniel J Sexton, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine
- Duke University Medical Center
The term asymptomatic bacteriuria refers to the presence of a positive urine culture in an asymptomatic person. Most patients with asymptomatic bacteriuria have no adverse consequences and derive no benefit from antibiotic therapy. As a result, most episodes of asymptomatic bacteriuria are not detected since general screening is not recommended. (See "Approach to the adult with asymptomatic bacteriuria".)
Issues related to asymptomatic bacteriuria in patients with diabetes mellitus will be reviewed here. Diabetic patients have an increased risk of certain symptomatic urinary tract infections such as acute cystitis, emphysematous infections, renal and perinephric abscess, and Candida infections. (See "Acute uncomplicated cystitis and pyelonephritis in women" and "Emphysematous urinary tract infections" and "Renal and perinephric abscess" and "Candida infections of the bladder and kidneys" and "Acute complicated cystitis and pyelonephritis".)
The discussion in this topic refers only to non-pregnant women. Asymptomatic bacteriuria in pregnancy is discussed in detail elsewhere. (See "Urinary tract infections and asymptomatic bacteriuria in pregnancy".)
DEFINITION AND DIAGNOSIS
The term asymptomatic bacteriuria refers to the presence of high quantities of an uropathogen in the urine of an asymptomatic person. Initial studies showed that colony counts ≥105 cfu/mL more often predicted persistently high levels of bacteriuria compared with lower colony counts .
Guidelines from the Infectious Diseases Society of America (IDSA) on asymptomatic bacteriuria in adults and catheter-associated urinary tract infections recommend the following criteria for the diagnosis of asymptomatic bacteriuria [2,3]:
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