Miroslav Šašinka, Katarína Furková
Asymptomatic bacteriuria (ABU) is the presence of a significant number of bacteria in a midstream clean-catch urine specimen (for women and girls: 2 consecutive specimens with isolation of at least 100 000 colony-forming units (cfu) per mL of the same bacterial species, for men and boys: a single specimen with isolation of at least 100 000 cfu/mL of a single bacterial species and in a catheterized urine specimen a single bacterial species isolated in a quantitative count of at least 100 cfu/mL for both women and men) in children and adults without clinical symptoms of the infection. These bacterial species are less virulent microorganisms without adhesins and inflammation, so ABU actually protects urinary tract against infection by pathogenic strains. Antibacterial therapy makes this protection ineffective, and is therefore not indicated in most ABU. In addition it does not improve prognosis or diminishes the number of complication. The exception is the ABU in pregnant women, in urologic procedures and in children under the age of 5-6 years. Asymptomatic bacteriuria in pregnant girls and women may cause the development of acute pyelonephritis and premature labor, so it is recommended to treat it. Similarly, ABU can be transformed to manifest pyelonephritis in surgical patients and young children and is therefore recommended to treat patients before surgery on the urogenital tract and children under the age of 5-6 years. In healthy school girls and young women, in diabetic women, in elderly ABU patients and in patients who have indwelling catheters or undergo intermittent urinary catheterization antibiotic prescription is not indicated.