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Pathogens. 2016 Jan 5;5(1). pii: E4. doi: 10.3390/pathogens5010004.

Asymptomatic Bacteriuria in Clinical Urological Practice: Preoperative Control of Bacteriuria and Management of Recurrent UTI.

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Department of Urology, Santa Chiara Regional Hospital, Largo Medaglie d'Oro 9, 38123 Trento, Italy.
Sexually Transmitted Disease Centre, Santa Maria Annunziata Hospital, 50012 Florence, Italy.
Department of Microbiology, Santa Chiara Regional Hospital, 38123 Trento, Italy.
Department of Laboratory Medicine, Santa Chiara Regional Hospital, 38123 Trento, Italy.
Department of Urology, Santa Chiara Regional Hospital, Largo Medaglie d'Oro 9, 38123 Trento, Italy.
Division of Pathological Anatomy, Department of Critical Care Medicine and Surgery, University of Florence, 50100 Florence, Italy.
Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Universitätsklinikum Giessen und Marburg GmbH, Justus-Liebig-Universität Giessen, 35390 Giessen, Germany.
Department of Urology, South-Pest Hospital, 1051 Budapest, Hungary.
Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE14XE, UK.
Department of Urology, Skåne University Hospital, University of Lund, S-20502 Malmö, Sweden.
Department of Urology, Oslo University Hospital, 0271 Oslo, Norway.
Department of Urology, University of Florence, 50012 Florence, Italy.


Asymptomatic bacteriuria (ABU) is a common clinical condition that often leads to unnecessary antimicrobial use. The reduction of antibiotic overuse for ABU is consequently an important issue for antimicrobial stewardship and to reduce the emergence of multidrug resistant strains. There are two issues in everyday urological practice that require special attention: the role of ABU in pre-operative prophylaxis and in women affected by recurrent urinary tract infections (rUTIs). Nowadays, this is the time to think over our practice and change our way of thinking. Here, we aimed to summarize the current literature knowledge in terms of ABU management in patients undergoing urological surgery and in patients with rUTIs. In the last years, the approach to patient with ABU has changed totally. Prior to all surgical procedures that do not enter the urinary tract, ABU is generally not considered as a risk factor, and screening and treatment are not considered necessary. On the other hand, in the case of all procedures entering the urinary tract, ABU should be treated in line with the results of a urine culture obtained before the procedure. In patients affected by rUTIs, ABU can even have a protective role in preventing symptomatic recurrence, particularly when Enterococcus faecalis (E. faecalis) has been isolated.


UTI; antibacterial agents; antibiotic susceptibility; asymptomatic bacteriuria; pre-operative prophylaxis; prophylaxis

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