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A wealth of evidence urges doctors to ignore asymptomatic bacteriuria (ASB), except in pregnant patients or those undergoing urological procedures. Still, many doctors worry that if positive urine cultures go untreated, calamity might result, especially when patients are sick and hospitalized.
Researchers retrospectively reviewed outcomes of 2772 cases of ASB identified during a 25-month period among inpatients in a Michigan hospital network. Most cases were in older women (median age, 77) who had been admitted to the hospital for reasons other than urinary tract infections (UTIs). All patients had positive urine cultures, almost all (94%) had pyuria, and none had documented urinary symptoms (although 20% were demented, and 13% had indwellin…