The role of asymptomatic bacteriuria in young women with recurrent urinary tract infections: to treat or not to treat?
BACKGROUND
Little is known about the role of asymptomatic bacteriuria (AB) treatment in young women affected by recurrent urinary tract infection (UTI). We aimed to evaluate the impact of AB treatment on the recurrence rate among young women affected by recurrent UTI.


METHODS
A total of 673 consecutive asymptomatic young women with demonstrated bacteriuria from January 2005 to December 2009 were prospectively enrolled. Patients were split into 2 groups: not treated (group A, n = 312) and treated (group B, n = 361). Microbiological and clinical evaluations were performed at 3, 6, and 12 months. Quality of life was also measured. Recurrence-free rate at the end of the entire study period was the main outcome measure.


RESULTS
At baseline, the 2 most commonly isolated pathogens were Escherichia coli (group A, 38.4%; group B, 39.3%) and Enterococcus faecalis (group A, 32.7%; group B, 33.2%). At the first follow-up visit, there was no difference between the 2 groups (relative risk [RR], 1.05; 95% confidence interval [CI], 1.01-1.10), whereas after 6 months, 23 (7.6%) in group A and 98 (29.7%) in group B showed recurrence with a statistically significant difference (RR, 1.31; 95% CI, 1.21-1.42; P < .0001). At the last follow-up, 41 (13.1%) in group A and 169 (46.8%) in group B showed recurrence (RR, 3.17; 95% CI, 2.55-3.90; P < .0001). One patient in group A and 2 patients in group B were found to have pyelonephritis.


CONCLUSIONS
This study shows that AB should not be treated in young women affected by UTI, suggesting it may play a protective role in preventing symptomatic recurrence.
Department of Urology, Santa Chiara Hospital, Trento, Italy. ktommy@libero.it
Tommaso
T
Cai
Sandra
S
Mazzoli
Nicola
N
Mondaini
Francesca
F
Meacci
Gabriella
G
Nesi
Carolina
C
D'Elia
Gianni
G
Malossini
Vieri
V
Boddi
Riccardo
R
Bartoletti
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D013293:Enterococcus faecalis / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D011446:Prospective Studies; D011788:Quality of Life; D055502:Secondary Prevention; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D055815:Young Adult