What is it and why does it happen
The urinary tract is not completely sterile, and in some people bacteria colonize the bladder without causing inflammation. The immune system keeps them under control, the mucous membrane is not damaged, and symptoms do not occur.
Asymptomatic bacteriuria is said to occur when a correctly collected urine culture reveals a significant amount of bacteria, but there are no complaints at all.
- Old age - frequency increases over the years, especially in women
- Female gender and anatomical features
- Diabetes mellitus
- Indwelling urethral catheter or cystostomy - with them there is almost always bacteriuria
- Neurogenic bladder and intermittent catheterization
- Pregnancy
- Urolithiasis and urinary tract abnormalities
- Condition after kidney transplantation
- Living in long-term care facilities
Why is it usually not treated?
This is perhaps the main practical question of the topic. Numerous observations have shown that antibiotic treatment of asymptomatic bacteriuria is not beneficial in most groups of patients.
- It does not reduce the incidence of subsequent symptomatic infections
- It does not improve kidney function or prevent kidney damage
- Bacteria return, often more resistant
- Antibiotic resistance develops, making it more difficult to find a drug for a real infection
- Side effects occur: disturbance of intestinal and vaginal microflora, allergies, diarrhea
- Time and money are wasted without clinical benefit
When is it necessary to treat
- Беременность — бактериурия значительно повышает риск пиелонефрита и осложнений беременности, поэтому скрининг и лечение обязательны
- Подготовка к операции или эндоскопическому вмешательству на мочевых путях с ожидаемым повреждением слизистой — например, к ТУР простаты или литотрипсии
- Ранний период после трансплантации почки — по решению врача
- Отдельные ситуации у пациентов с иммуносупрессией и нейтропенией — решает лечащий врач
In all these cases, treatment is carried out according to the results of culture with determination of sensitivity, and not at random, and with a mandatory control analysis after the course.
When treatment is usually not necessary
- Healthy non-pregnant women of any age without complaints
- Older people living at home or in care facilities without symptoms
- Patients with diabetes mellitus in stable condition and no complaints
- Patients with an indwelling urethral catheter or cystostomy without signs of infection
- Patients with neurogenic bladder undergoing intermittent catheterization
- Patients after spinal cord injury without clinical manifestations
- Patients with a nephrostomy or stent without symptoms - but with mandatory observance of replacement dates
What to do if bacteria are found by accident
- Не начинать антибиотик самостоятельно
- Убедиться, что нет симптомов: резей, частых позывов, боли в пояснице, температуры
- Проверить, правильно ли была собрана моча — нарушение техники сбора часто даёт ложный результат
- Обсудить ситуацию с врачом с учётом беременности, планируемых операций, диабета и других обстоятельств
- При отсутствии показаний — наблюдать, а не лечить
- Обратиться немедленно, если появятся симптомы: тогда это уже инфекция, требующая терапии
How to properly submit a urine culture
- Collect the morning portion after a night break
- Carry out hygiene of the external genitalia without antiseptics
- Collect the middle portion: start urinating into the toilet, then replace the container
- Use a sterile container without touching the inside
- Deliver to the laboratory within the next few hours or store in the refrigerator
- Do not take during menstruation
- Do not test while taking an antibiotic - the result will be false negative
A significant part of “bad” analyzes is explained precisely by collection errors, and not by a real problem. The correct technique eliminates unnecessary anxiety and unnecessary treatment.
Where to get advice in Tashkent
A urologist will help you figure out whether your situation requires treatment by assessing your complaints, concomitant diseases and planned interventions.
In Tashkent, such consultation and examination for repeated bacteriuria can be obtained at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
If you are having surgery on the urinary tract, be sure to get a urine culture in advance: this is the case when asymptomatic bacteriuria really requires treatment before surgery. Clinic contacts are below.
