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Asymptomatic Bacteriuria in Young Women

Young women occasionally are found to have asymptomatic bacteriuria, but the natural history of this "disorder" is unclear. In this 6-month study, researchers at the University of Washington performed urine cultures monthly among 348 university students and bimonthly among 448 HMO enrollees. All women were asymptomatic, sexually active, and between 18 and 40 years old; none were pregnant.

Overall, 5 percent of cultures were positive (100,000 colony-forming units/mL). About 22 percent of women had at least 1 episode of asymptomatic bacteriuria, and 5 percent had 2 consecutive episodes. When women had 2 consecutive positive cultures, genetic typing revealed that the second organism was generally, but not always, the same as the first. Eight percent of episodes of asymptomatic bacteriuria were followed by a symptomatic urinary tract infection (UTI) within 1 week. The most potent risk factors for asymptomatic bacteriuria were recent use of a diaphragm plus spermicide and recent sexual intercourse.

Comment: These results suggest that asymptomatic bacteriuria in young women is reasonably common, is often transient, is associated with sexual activity, and is followed by symptomatic UTI in a small percentage of cases. Clinicians often are tempted to prescribe antibiotics to healthy young nonpregnant women with asymptomatic bacteriuria, but there is no evidence to justify that practice.

— AS Brett

Published in Journal Watch General Medicine October 13, 2000

Citation(s):

Hooton T et al. A prospective study of asymptomatic bacteriuria in sexually active young women. N Engl J Med 2000 Oct 5 343 992-997.

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