Kenneth Lin, MD; Kevin Fajardo, MD, MPH, MTMH
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Acknowledgment: The authors thank Marion Torchia, Office of Communications and Knowledge Transfer, Agency for Healthcare Research and Quality, for helpful and timely editorial support.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Kenneth Lin, MD, Center for Primary Care, Prevention, and Clinical Partnerships, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850; e-mail, email@example.com.
Current Author Addresses: Drs. Lin and Fajardo: Center for Primary Care, Prevention, and Clinical Partnerships, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850
Asymptomatic bacteriuria is common, and screening for this condition in pregnant women is a well-established, evidence-based standard of current medical practice. Screening other groups of adults has not been shown to improve outcomes.
To review new and substantial evidence on screening for asymptomatic bacteriuria, to support the work of the U.S. Preventive Services Task Force.
English-language studies of adults (age >18 years) indexed in PubMed and the Cochrane Library and published from 1 January 2002 through 30 April 2007.
For benefits of screening or treatment for screened populations, systematic reviews; meta-analyses; and randomized, controlled trials were included. For harms of screening, systematic reviews; meta-analyses; randomized, controlled trials; cohort studies; case–control studies; and case series of large multisite databases were included. Two reviewers independently reviewed titles, abstracts, and full articles for inclusion.
Two reviewers extracted data from studies on benefits of screening and treatment (including decreases in the incidence of adverse maternal and fetal outcomes, symptomatic urinary tract infections, hypertension, and renal function decline).
An updated Cochrane systematic review of 14 randomized, controlled trials of treatment supports screening for asymptomatic bacteriuria in pregnant women. A randomized, controlled trial and a prospective cohort study show that screening nonpregnant women with diabetes for asymptomatic bacteriuria is unlikely to produce benefits. No new evidence on screening men for asymptomatic bacteriuria or on harms of screening was found.
The focused search strategy may have missed some smaller studies on the benefits and harms of screening for asymptomatic bacteriuria.
The available evidence continues to support screening for asymptomatic bacteriuria in pregnant women, but not in other groups of adults.
What are the benefits of screening and treatment for asymptomatic bacteriuria in pregnant women, nonpregnant women, and men?
What are the harms of screening for asymptomatic bacteriuria in pregnant women, nonpregnant women, and men?
Study flow diagram.
RCT = randomized, controlled trial; UTI = urinary tract infection.
Table. New Studies on the Benefits of Screening and Treatment for Asymptomatic Bacteriuria
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Kenneth Lin, Kevin Fajardo. Screening for Asymptomatic Bacteriuria in Adults: Evidence for the U.S. Preventive Services Task Force Reaffirmation Recommendation Statement. Ann Intern Med. 2008;149:W–20–W–24. doi: 10.7326/0003-4819-149-1-200807010-00009-w1
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Published: Ann Intern Med. 2008;149(1):W-20-W-24.
Guidelines, Infectious Disease, Nephrology, Urinary Tract Infection, Urological Disorders.
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