The US Preventive Services Task Force (USPSTF) yesterday recommended that only pregnant women should be screened for asymptomatic bacteriuria (ASB), based on findings of a moderate net benefit in reducing perinatal complications.
The findings appear in an evidence report, published yesterday in JAMA, that found that screening and treatment for ASB—the presence of bacteria in the urine in the absence of signs or symptoms of a urinary tract infection—in pregnant women during the first prenatal visit was associated with reduced rates of pyelonephritis and low birth weights. But the grade for the USPSTF recommendation was lowered from A (high certainty of a net benefit) to B (moderate certainty).
“The USPSTF changed the grade for pregnant persons from an ‘A’ to a ‘B’ based on the reduced applicability of the previous evidence that included outdated antibiotic treatment regimens and newer evidence that shows a significantly lower risk of pyelonephritis than found in previous reviews,” the task force says in its recommendation statement. “In addition, there are newer concerns about antibiotic use, such as antimicrobial resistance and adverse changes to the microbiome (not addressed in current studies), leading to an increase in the magnitude of potential harms.”
The Task Force continues to recommend against screening for ASB in nonpregnant women or healthy men, noting that there is a moderate or high certainty the service has no net benefit (D grade).
The USPSTF is an independent panel of national experts in prevention and evidence-based medicine that makes recommendation on screenings, counseling services, and preventive medications. Its recommendations on ASB screening, which apply to adults and pregnant women of any age without signs or symptoms of a urinary tract infection, were last updated in 2008.
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Culture of routine urine testing
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