Does my patient really have a UTI?

Treating asymptomatic bacteriuria can have negative effects for patients. UNC Medical Center Hospital Epidemiology and the UNC Antimicrobial Stewardship Program are teaming up to spread the word.

Treating asymptomatic bacteriuria can have negative effects for patients, and UNC Medical Center Hospital Epidemiology and the UNC Antimicrobial Stewardship Program are teaming up to spread the word.

In cases of asymptomatic bacteriuria, patients’ urine may be colonized with bacteria, but they do not have signs or symptoms of urinary tract infection (UTI).  Evidence shows that treatment of asymptomatic bacteriuria does not benefit patients but does increase healthcare costs, hospital lengths of stay, and may precipitate C. difficile infections and antimicrobial resistance.  Patients who should be treated for asymptomatic bacteriuria are patients who are undergoing urologic surgery and pregnant patients. Urinalysis and urine culture are useful screening tests for patients with urinary tract symptoms such as urinary frequency, burning, and pain.  However, these tests are neither sensitive nor specific for predicting UTI in patients without urinary symptoms. 


A simple two-step algorithm for determining whether patients need UTI therapy is: 1) Does my patient have urinary symptoms? And 2) Are these symptoms explained by other non-urinary diagnoses? A resource flyer  on appropriate testing for UTIs can be found at this link. https://uncmedicalcenter.intranet.unchealthcare.org/dept/Epidemiology/Documents/CAUTI/CAUTI%20Flyer%208-1-18.pdf


For more information, please contact Hospital Epidemiology or the Antimicrobial Stewardship Program. 

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