Asymptomatic bacteriuria (ASB) is a condition in which women have positive urine cultures for bacteria in the urinary tract without having any symptoms of a urinary tract infection, such as painful urination. This condition can be common in pregnancy and is associated with an increased risk of developing urinary tract infections and pyelonephritis, which in turn can increase the risks of preterm birth and complications for both mother and infant.
ASB can be diagnosed by midstream urine culture in settings where this method is available. However, the high resource costs associated with Gram staining may make this less suitable in low-resource settings. In such cases, on-site midstream urine dipstick testing may be appropriate as an alternative.
Screening for ASB is recommended at the earliest possible opportunity during pregnancy. This is especially important in the first and second trimesters as ASB increases the risk of symptomatic UTIs and pyelonephritis, both of which are serious problems during pregnancy. It is also essential to monitor the presence of ASB as part of routine antenatal care, and this should be adopted in practice to improve pregnancy outcomes, reduce maternal and neonatal morbidity and reduce antibiotic use.
Treatment for ASB is usually a short course of oral antibiotics that can be given during pregnancy. This will usually be followed by prophylaxis for a further seven days to help prevent recurrence of ASB.
Drink lots of water and other fluids to help flush bacteria out of your body. Try to urinate at least twice a day and wipe from front to back after each bowel movement. A healthy diet with plenty of fruit and vegetables is also a good idea.
Eat foods rich in vitamin C, such as cranberries. These foods have been found to slow bacterial growth in your urinary tract. You can also take a supplement that contains vitamin C, such as echinacea or ginseng. These supplements can also lower your risk of ASB and pyelonephritis.
ASB can be treated with a short course of antibiotics, usually at the doctor’s discretion. You should follow your doctor’s instructions carefully, as some antimicrobial drugs can cause side effects in pregnant women.
The most common microbial pathogens associated with ASB in pregnant women are Escherichia coli and Klebsiella species, but other bacteria can also cause it. A urethra that is too short and prone to irritation can also contribute to ASB, so it is important to have a hygienic urethra throughout your pregnancy.
Identify and treat asymptomatic bacteriuria in pregnant women with midstream urine cultures as soon as possible to reduce the risk of symptomatic urinary tract infections and pyelonephritis. This will reduce the risk of complications for both mother and infant and is an effective way to save money in health care.
ASB is a common and serious problem for many pregnant women. Often, ASB is detected late in pregnancy, and once diagnosed, it is usually treated with a course of antibiotics to prevent symptomatic urinary tract infections and bacterial pyelonephritis. A large randomized controlled trial found that this approach is not only safe, but also effective in treating ASB during pregnancy.
