01 Oct USPSTF Recommends Clinicians Screen All Pregnant Women for Asymptomatic Bacteriuria

MedicalResearch.com Interview with:

Dr. Simon

Melissa A. Simon, M.D., M.P.H.
Member, U.S. Preventive Services Task Force
George H. Gardner professor of clinical gynecology, Vice chair of clinical research
Department of Obstetrics and Gynecology
Professor of preventive medicine and medical social sciences
Northwestern University Feinberg School of Medicine 

MedicalResearch.com: What is the background for this study?

Response: Asymptomatic bacteriuria, or ASB, is when someone has bacteria in their urine but does not have any signs or symptoms of a urinary tract infection. For pregnant people, this can be a major health concern resulting in severe, even life-threatening, infections that can lead to serious harms for both the mother and the baby.

The Task Force’s primary finding in updating its recommendation on this topic was that screening for ASB continues to be beneficial in preventing complications and preserving the health of mothers and their babies during pregnancy. 

MedicalResearch.com: What are the main findings?

Response: The key takeaway from this recommendation is that clinicians should continue screening all pregnant patients for ASB during their first prenatal visit and, if necessary, treat it with antibiotics. However, the Task Force recommends against screening for ASB in non-pregnant adults because it is not beneficial among this population. 

MedicalResearch.com: What should readers take away from your report?

Response: The Task Force is encouraging new studies among pregnant people that evaluate the risk of serious complications related to asymptomatic bacteriuria, such as pyelonephritis, which is a very serious kidney infection. Further research is also needed to help better understand the benefits and harms of antibiotic treatment for ASB on the mother and baby.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: This recommendation changed from an A to a B grade because the balance of benefits and harms has shifted since the Task Force last reviewed this topic in 2008. Notably, while the evidence shows the risk of the kidney infection pyelonephritis has gone down for pregnant people, there is now increased concern around the use of antibiotics.

It is also important to note that this recommendation does not apply to people who are hospitalized, have certain chronic medical and urinary tract conditions, are living in a nursing home, or are transplant recipients.

No disclosures 

Citation:

Henderson JT, Webber EM, Bean SI. Screening for Asymptomatic Bacteriuria in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2019;322(12):1195–1205. doi:10.1001/jama.2019.10060

https://jamanetwork.com/journals/jama/fullarticle/2751725 

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Last Updated on October 1, 2019 by Marie Benz MD FAAD