Asymptomatic bacteriuria prevalence

Shaikh N, Osio VA, Wessel CB, Jeong JH. Prevalence of Asymptomatic Bacteriuria in Children: A Meta-Analysis. J Pediatr 2020;217:110-7.e4. Among well children, what is the prevalence of asymptomatic bacteriuria (AB)? Systematic review and meta-analysis of studies measuring prevalence of AB. International. Asymptomatic children, 0-19 years of age. Bladder catheterization, suprapubic aspiration, or 3 consecutive clean catch urine samples. >1 organism with 100 000 colony forming units per milliliter (CFU/mL) for samples obtained by catheterization and 10 000 CFU/mL for samples obtained using suprapubic aspiration, with and without pyuria. 14 studies (49 806 children) demonstrated an overall AB prevalence of 0.37% (95% CI, 0.09-0.82) and 0.47% (95% CI, 0.36-0.59), and an AB prevalence without pyuria of 0.18% (95% CI, 0.02-0.51) and 0.38% (95% CI, 0.22-0.58), in boys and girls, respectively. Median AB duration from one study was 1.5 – 2 months. AB prevalence is notably lower than that of urinary tract infection (UTI) in most subgroups, and therefore, a negative urinalysis (UA) with growth on urine culture should not be assumed to exclude a UTI.