When is Bacteria Not an Infection?

by Alex Shteynshlyuger MD


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Bacteria in Urine – Common Finding in Women

UTI in WomenBacteria in urine is a fairly common finding on urinalysis in women.  While ideally, there should be no bacteria in urine, commonly routine urinalysis picks up some bacteria.  Occasionally the number of bacteria sufficient enough that urine culture may be positive.

If I Have Bacteria in My Urine Does it Mean I Have an Infection?

The presence of bacteria in urine is called bacteriuria.  Infection occurs when his bacteriuria causes problems and symptoms such as frequent urination, pain and burning in the bladder or urethra.   Bacteria in urine that does not cause any problems or symptoms is called “asymptomatic bacteriuria”.  Asymptomatic bacteriuria is common in women, but infrequent in men.

In general, if bacteria do not cause a problem, there is no need for treatment.  The only exceptions are women who are pregnant, especially as they get closer to a due date.  Pregnant women usually require treatment for bacteriuria.  Patients who are about to undergo surgical procedures that involve the urinary tract, cardiac surgery or implantation of foreign devices such as metal knees or hip replacement may benefit from treatment of asymptomatic bacteriuria before surgery.

What Evaluation is Necessary for Asymptomatic Bacteriuria?

For most patients, especially younger women, with occasional bacteria in urine that does not cause symptoms, no evaluation is necessary.

For patients with persistent bacteriuria, ultrasound of the kidney and bladder may be beneficial to evaluate for kidney stones and other causes of persistent bacteria in urine.  For some patients with diabetes and neurological conditions such as multiple sclerosis, kidney, and bladder ultrasound is advisable.

Some patients with previous bladder or vaginal surgery and patients with a history of diverticulitis may also need cystoscopy to evaluate for foreign devices such as sutures, strictures, and fistulas depending on the clinical situation.


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call:

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