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Asymptomatic Bacteriuria

Hate to break it to you preppers and pranksters. Urine is not clean.

“Urine is sterile.” It’s a dogma that dates back to the 1800’s and has been embraced by preppers and pranksters alike. This belief originated from the observations of Louis Pasteur and company, who showed that a vial of urine in a sealed container did not turn cloudy, in contrast to a vial of urine exposed to air or with added tap water. In other words, this myth was born in an era when microbiology was at its infancy and all bacteria were considered harmful. Today, we can resolutely say that,

Urine is not sterile.

Under normal circumstances, urine can have bacteria. People can often have a significant amount of bacteria without any symptoms. This clinically silent presence of bacteria in the urine is what’s known as “asymptomatic bacteriuria”.

What is asymptomatic bacteriuria?

Our body is teeming with bacteria so it may be no surprise to find bacteria in a urine sample. But the presence of more than the normally expected quantity of bacteria in urine, without symptoms of urinary tract infection, is considered asymptomatic bacteriuria. In most cases, 

asymptomatic bacteriuria does not need treatment. It usually goes away on its own and does not lead to problems. Certain populations, however, should be screened and treated for bacteria in their urine, even if they have no signs or symptoms of urinary tract infection.

How is asymptomatic bacteriuria diagnosed?

The diagnosis of asymptomatic bacteriuria is made by urine culture via either a mid-stream urine sample or catheterized urine sample. 

Does asymptomatic bacteriuria need to be treated?

Most people with asymptomatic bacteriuria do not need antibiotics. Needlessly treating asymptomatic bacteriuria can cause side effects such as nausea, vomiting, diarrhea, and promote antibiotic resistance. In certain cases, however, the bacteria can lead to an infection and cause problems. Doctors will prescribe antibiotics for asymptomatic bacteriuria in patients who are:

  • Pregnant

  • Planning to have a certain type of surgery involving the urinary tract or genital area

  • Kidney transplant recipients

With the dogma debunked, think twice before chugging a glass of urine.


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