Asymptomatic Bacteriuria

Approximately 5% of reproductive-age women have asymptomatic bacteriuria (Bent et al., 2002). It is also common in older adults. This is important for understanding the community risk of UTI when evaluating a patient with UTI symptoms. However, although asymptomatic bacteriuria may conceptually place a patient at risk for UTI, identification and treatment do not appear to affect morbidity or mortality (Gartlehner et al., 2004; Lin and Fajardo, 2008). Thus, bacteriuria screening is not recommended (USPSTF, 2008a).

In contrast, pregnant women do benefit from screening. Testing with urine culture should be done in all pregnant women at 12 to 16 weeks of gestation (USPSTF, 2008a). Urine culture is the best method, because dipstick testing

Figure 40-14 Crusted lesions of genital herpes on penile shaft. (From CDC Public Health image Library image 6480. Courtesy Susan Lindsley.)
Figure 40-15 Chancre of primary syphilis. (From CDC Public Health Image Library image 6803. Courtesy Dr. M. Rein.)

and microscopy are not accurate enough tests to predict this condition.

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