Department of Internal Medicine, School of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Division of Infectious Diseases, Veterans Affairs Boston Healthcare System and Boston University School of Medicine, West Roxbury, Massachusetts.
Clin Infect Dis. 2019 May 2;68(10):1611-1615. doi: 10.1093/cid/ciz021.
Asymptomatic bacteriuria (ASB) is a common finding in many populations, including healthy women and persons with underlying urologic abnormalities. The 2005 guideline from the Infectious Diseases Society of America recommended that ASB should be screened for and treated only in pregnant women or in an individual prior to undergoing invasive urologic procedures. Treatment was not recommended for healthy women; older women or men; or persons with diabetes, indwelling catheters, or spinal cord injury. The guideline did not address children and some adult populations, including patients with neutropenia, solid organ transplants, and nonurologic surgery. In the years since the publication of the guideline, further information relevant to ASB has become available. In addition, antimicrobial treatment of ASB has been recognized as an important contributor to inappropriate antimicrobial use, which promotes emergence of antimicrobial resistance. The current guideline updates the recommendations of the 2005 guideline, includes new recommendations for populations not previously addressed, and, where relevant, addresses the interpretation of nonlocalizing clinical symptoms in populations with a high prevalence of ASB.
无症状性菌尿症(ASB)在许多人群中较为常见,包括健康女性和存在潜在泌尿系统异常的人群。美国传染病学会 2005 年的指南建议,仅对孕妇或即将接受侵入性泌尿系统检查的个体进行 ASB 的筛查和治疗。不建议对健康女性、老年女性或男性、患有糖尿病、留置导管或脊髓损伤的个体进行治疗。该指南未涉及儿童和一些成人人群,包括中性粒细胞减少症、实体器官移植和非泌尿系统手术的患者。自该指南发布以来,与 ASB 相关的更多信息已经公布。此外,ASB 的抗菌治疗已被确认为不适当使用抗菌药物的一个重要原因,这促进了抗菌药物耐药性的出现。本指南更新了 2005 年指南的建议,包括对以前未涉及的人群的新建议,并在相关情况下,对高 ASB 流行人群中无定位临床症状的解释进行了说明。