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Asymptomatic Bacteriuria in Pregnancy

Comments from Expert Advisory Committee

  • Asymptomatic bacteriuria is the presence of 1 or more species of bacteria growing in the urine at a quantitative count of >105 colony-forming units/mL, without signs or symptoms attributable to urinary tract infection.
  • Asymptomatic bacteriuria occurs in 2% to 7% of pregnant women.
  • Antibiotic treatment of asymptomatic bacteriuria reduces the risk of pyelonephritis, low birth weight and premature labour.
  • A urine culture is usually requested early in pregnancy (12-16 weeks).
  • The presence of asymptomatic bacteriuria should be confirmed by two consecutive urine cultures (preferably within two weeks).
  • Urine culture remains the gold standard in detection of asymptomatic bacteriuria.
  • Dipstick testing is not sufficient to screen for bacterial UTIs in pregnancy.
  • A positive urine culture for bacteriuria in the second sample of urine should be treated with an appropriate antibiotic for the bacteria isolated and the trimester of pregnancy.
  • Confirm clearance with urine culture after treatment.
  • Repeat urine cultures at subsequent antenatal visits may be required for prior recurrent UTI’s, diabetes mellitus, renal anomaly.
  • Trimethoprim should not be prescribed for pregnant women with established folate deficiency, low dietary folate intake, or women taking other folate antagonists.

Treatment

ABin Pregnancy table jan 28

Patient Information

Safe Prescribing (visit the safe prescribing page)

Reviewed Jan 2021