Bacteremia from Asymptomatic Bacteriuria Is Both Rare and Hard to Predict

Despite guideline recommendations against antibiotics for asymptomatic bacteriuria (ASB; NEJM JW Emerg Med Jun 2019 and Clin Infect Dis 2019; 68:e83), antibiotic treatment for patients with ASB and nonspecific symptoms remains common. In this retrospective study, researchers estimated the prevalence of bacteremia from a urinary source (i.e., isolation of identical organisms from blood and urine cultures collected within 3 days of each other) among 11,600 hospitalized noncritically ill adults with ASB at 68 hospitals in Michigan; data were obtained by standardized review of individual charts and were not simply administrative data. Patients with specific signs or symptoms of urinary tract infection (UTI) and patients who received antibiotics…