USPSTF Curbs Enthusiasm on Screening for Asymptomatic Bacteriuria

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

The U.S. Preventive Services Task Force continues to recommend screening pregnant women for asymptomatic bacteriuria, similar to the group's 2008 recommendations. However, the certainty of the evidence is now a B grade instead of an A, meaning that there is a moderate net benefit in reducing risk for perinatal complications.

The change comes as fewer pregnant women with untreated asymptomatic bacteriuria have developed pyelonephritis in recent years. In addition, concerns about antibiotic use have come to light, including antimicrobial resistance and changes to the microbiome.

The USPSTF recommends screening pregnant women using a single midstream, clean-catch urine culture at either the first prenatal visit or at 12-16 weeks' gestation, whichever occurs first.

For nonpregnant women and men, the task force recommends against screening for asymptomatic bacteriuria.