USPSTF Urges Asymptomatic Bacteriuria Screen in Pregnancy

The U.S. Preventive Services Task Force (USPSTF) recommends screening pregnant women for asymptomatic bacteriuria (ASB) but not nonpregnant women or men. These recommendations form the basis of a draft recommendation statement published online by the USPSTF.

Jillian T. Henderson, Ph.D., M.P.H., from the Kaiser Permanente Center for Health Research in Portland, Oregon, and colleagues conducted a systematic review on the benefits and harms of screening for ASB and treatment for pregnant women, nonpregnant women, and men. Data were included from 19 studies of screening or treatment of ASB; 14 were conducted among pregnant women. Two studies on pregnant women examined the effectiveness and/or harms of screening (5,289 women) and 12 examined the effectiveness and harms of treatment (2,377 women). Five studies examined the effectiveness and harms of treatment in nonpregnant women and men (777 adults), focusing mainly on women.

The researchers noted some evidence that treatment of urine culture screen-detected ASB conferred benefit to maternal and infant health, with a reduction in the risk for pyelonephritis (pooled relative risk, 0.24). In nonpregnant populations, the investigators found no evidence that treatment is beneficial to health. Based on these findings, the USPSTF recommends screening for ASB in pregnant persons with urine culture (B recommendation) and recommends against screening for ASB in nonpregnant adults (D recommendation).

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