What is the medical term for bacteria in urine?

Medical Term for Bacteria in Urine

The medical term for the presence of bacteria in urine is "bacteriuria." This is a microbiologic diagnosis determined through appropriate urine specimen collection and laboratory analysis 1.

Types of Bacteriuria

Bacteriuria can be classified into two main categories:

1. Asymptomatic Bacteriuria (ASB):

   • Defined as the isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen obtained from a person without symptoms or signs referable to urinary tract infection 1, 2
   • Diagnostic criteria:
     • Women: Two consecutive voided urine specimens with isolation of the same bacterial strain in quantitative counts ≥10^5 CFU/mL 1, 2
     • Men: A single clean-catch voided urine specimen with one bacterial species isolated in a quantitative count ≥10^5 CFU/mL 1, 2
     • Catheterized specimens: ≥10^2 CFU/mL 2

2. Symptomatic Bacteriuria (UTI):

   • Presence of bacteria in urine accompanied by symptoms such as frequency, urgency, dysuria, or suprapubic pain 1
   • May be classified as:
     • Acute uncomplicated urinary tract infection
     • Acute nonobstructive pyelonephritis
     • Complicated urinary tract infection 1

Diagnostic Considerations

• Collection method matters: Specimens should be collected in a manner that minimizes contamination and transported to the laboratory promptly 1
• Quantitative definition: The standard definition is 10^5 CFU/mL in properly collected specimens 1
• Gold standard: Urine culture is the definitive test for detecting bacteriuria, not dipstick or microscopy 2
• Pyuria: The presence of increased numbers of polymorphonuclear leukocytes in the urine indicates an inflammatory response in the urinary tract but is not sufficient for diagnosis 1

Clinical Significance and Management

The clinical approach to bacteriuria depends on whether it is symptomatic or asymptomatic:

• Asymptomatic bacteriuria:
  • Generally should NOT be treated with antibiotics in most populations 1, 2
  • Treatment recommendations vary by population:

Population	Recommendation	Strength of Evidence
Pregnant women	Screen and treat	A-I
Patients undergoing urological procedures with risk of mucosal bleeding	Screen and treat	A-I to A-III
Non-pregnant adults	Do not screen or treat	A-I
Diabetic patients	Do not screen or treat	A-I
Community-dwelling older adults	Do not screen or treat	A-II

• Symptomatic bacteriuria (UTI):
  • Requires appropriate antimicrobial therapy based on culture and susceptibility results 2
  • Treatment should target the specific pathogen with the narrowest spectrum effective antibiotic 2

Common Causal Microorganisms

The prevalence and etiology of bacteriuria vary across different patient populations 3. Escherichia coli is the most common etiologic agent in both symptomatic and asymptomatic bacteriuria 4, but other organisms may be involved depending on patient factors and comorbidities.

Important Clinical Pitfalls

• Avoid treating ASB unnecessarily: Treatment of asymptomatic bacteriuria does not improve clinical outcomes in most populations and may lead to antimicrobial resistance 2, 5, 6
• Don't confuse contamination with bacteriuria: High squamous cell counts suggest contamination rather than true bacteriuria 2
• Pyuria with ASB is NOT an indication for treatment: The presence of pyuria accompanying asymptomatic bacteriuria does not warrant antimicrobial therapy 2
• Recognize special populations: Pregnant women and patients undergoing certain urologic procedures are exceptions where screening and treatment of ASB is beneficial 2, 4

Understanding the distinction between asymptomatic bacteriuria and symptomatic UTI is crucial for appropriate management and antibiotic stewardship.