When should asymptomatic bacteriuria be treated?

Asymptomatic bacteriuria, defined as the presence of bacteria in the urine without accompanying symptoms of a urinary tract infection (UTI), does not typically require treatment in most populations. However, there are specific circumstances where treatment is warranted, such as in pregnant patients and those undergoing certain urological procedures.

In pregnant patients, asymptomatic bacteriuria can lead to serious complications like pyelonephritis, preterm labor, and low birth weight if left untreated, making it crucial to screen for and treat this condition. Furthermore, individuals undergoing specific urological procedures that could introduce bacteria into the urinary tract, such as a cystoscopy or urinary tract surgery, are also at risk of developing symptomatic infections if their asymptomatic bacteriuria is not addressed. Therefore, it is recommended to treat these patients to prevent potential complications.

The other options imply situations where treatment is generally not necessary. In healthy adults, asymptomatic bacteriuria usually resolves on its own without causing any harm. Similarly, in patients with no underlying conditions, treatment is not typically indicated. Lastly, while older adults may experience bacteriuria alongside urinary incontinence, it is still often considered asymptomatic unless there are signs of an active infection.