Asymptomatic Bacteriuria (Bacteria in Urine, No Symptoms)

What is asymptomatic bacteriuria?

Asymptomatic bacteriuria means you have bacteria in your urine but you have no symptoms of infection. If you are healthy, this condition is usually not a problem and not something that your healthcare provider needs to check for. However, it can cause complications if you are pregnant, have had a kidney transplant, or have certain other medical conditions. If you have one of these conditions, you will be checked for asymptomatic bacteriuria.

How does it occur?

Urine is normally sterile, which means that it contains no bacteria. A small number of bacteria may be found in the urine of many healthy people. This is usually considered to be harmless. However, a certain level of bacteria can mean that the bladder, urethra, or kidneys are infected.

Anything that blocks the flow of urine or prevents the bladder from emptying completely can cause bacteria to grow in the urine. For example, a stone or tumor might block the flow of urine. Prostate enlargement in men might also cause such a block.

This problem occurs more often in women than men because a woman's urethra is shorter. (The urethra is the tube that empties urine from the bladder.) The short urethra makes it easier for bacteria from the anus or genital area to reach the bladder. This can happen during such activities as sex or wiping after using the toilet. Most infections of the urinary tract are caused this way. Bacteria can also enter the urine through the bloodstream, but this is rare.

What are the symptoms?

Asymptomatic bacteriuria has no symptoms.

How is it diagnosed?

Your healthcare provider may examine you. Your provider may ask you to provide 2 urine samples about a week apart. The urine samples will be tested for bacteria. You may also have some blood tests.

If you have bacteria in your urine more than once, you may have:

• more blood tests
• a special X-ray of the kidneys called an intravenous pyelogram (IVP)
• an ultrasound scan.

The IVP and ultrasound scan can show problems in the urinary tract.

How is it treated?

If you are healthy, asymptomatic bacteriuria is usually not a problem and usually does not require treatment.

If you have a medical conditions in which asymptomatic bacteriuria can be a problem, you may be prescribed an antibiotic, especially if:

• You are pregnant. (The infection could cause a low-birth-weight baby or it may cause you to go into labor too early.)
• You are going to have tests or surgery on your bladder or other organs of the urinary tract.
• You have a blockage of your urinary tract, such as a kidney stone.

If you are treated with an antibiotic, you may need to have your urine tested again after you have taken all of the medicine. Your provider may recommend additional follow-up tests of your urine to see if the problem comes back.

In some cases, regular urine testing rather than antibiotic treatment may be the best course. Your provider will determine what treatment is best for you.

How long will the effects last?

Asymptomatic bacteriuria usually clears up after treatment with antibiotics. However, it can come back.

If this problem is not treated, it could become a full-blown urinary tract infection. If the infection is not then treated with antibiotics, the kidneys could be damaged.

How can I take care of myself?

• If you were prescribed an antibiotic, take all of it as prescribed, even if you have no symptoms. Do not take medicine left over from previous infections.
• Drink plenty of water each day to cleanse the bladder and urinary tract.
• Follow your healthcare provider's recommendation for follow-up urine testing to check for recurrence.

What can I do to help prevent asymptomatic bacteriuria?

Women can take the following steps to help prevent a bladder infection from recurring:

• Drink plenty of fluids.
• Urinate regularly during the day. Empty your bladder completely each time.
• Keep the vaginal area clean. Wipe from front to back after using the toilet.
• Urinate before and after intercourse.
• Wear cotton underwear, which allows better air circulation than nylon. Wear pantyhose that have a cotton crotch.
• Avoid tight clothes in the genital area, such as control-top pantyhose and tight jeans. Do not wear a wet bathing suit for long periods of time.

If you have a history of recurrent urinary tract problems, your healthcare provider may prescribe antibiotics to be taken either daily or after every time you have sexual intercourse.