Reconsidering asymptomatic bacteriuria and contamination as causes of bacteriuria without pyuria

Shaikh et  al performed a meta-analysis to determine the prevalence of asymptomatic bacteriuria in children.1 The clinical issue is whether a positive urine culture with a negative urinalysis represents a urinary tract infection (UTI) or asymptomatic bacteriuria. The authors calculate the rate of bacteriuria without pyuria (the working definition of asymptomatic bacteriuria) to be 0.18% in boys and 0.38% in girls. They compare these rates with the 5% rate of what they call “UTIs,” determine the rate of asymptomatic bacteriuria to be “at least an order of magnitude less than the prevalence of UTI, ” and conclude that “the current definition of UTI should be revisited.”1 However, the majority of the 5% have both bacteriuria and pyuria and clearly have a UTI, not asymptomatic bacteriuria.
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Tags: Letter to the editor Source Type: research