Guidelines
Asymptomatic Bacteriuria in Surgery Patients

Asymptomatic Bacteriuria in Surgery Patients

Definition

  • Presence of 1 or more bacteria in the urine at ≥105 CFU/mL or ≥108 CFU/L
  • Absence of signs or symptoms attributable to urinary tract infection (i.e. urinary urgency, fever, etc.)
  • Irrespective of presence of pyuria

Recommendations

Screening for or treating asymptomatic bacteriuria in non-urologic surgery patients is NOT recommended (includes orthopedic and cardiothoracic procedures)

  • Urologic surgery is the ONLY surgery in which screening for and treating ASB is recommended
  • Short course (1 or 2 doses) recommended versus longer course, if ASB is found and treated

More Information

  1. Nicolle LE et al. IDSA Asymptomatic Bacteriuria Guidelines. Clin Infect Dis. 2019;68(10):e83-e110. doi:10.1093/cid/ciy1121
  2. Cordero-Ampuero J et al. Are antibiotics necessary in hip arthroplasty with asymptomatic bacteriuria? Clin Orthop Relat Res 2013; 173:71-2.
  3. Sousa RJ et al. Is asymptomatic bacteriuria a risk factor for prosthetic joint infection? Clin Infect Dis 2014; 59:41-7
  4. Duarte JC et al. Bacteriuria is not associated with surgical site infection in patients undergoing cardiovascular surgery. Am J Infect Control. 2018;46(2):180-185.
  5. Drekonja DM et al. Preoperative urine cultures at a Veterans Affairs medical center. JAMA Intern Med 2013; 173:71-2
  6. Salazar JG et al. Association of screening and treatment for preoperative ASB with postoperative outcomes among US veterans. JAMA Surg 2019; 154(3):241-248.