Pyelonephritis Screening: Difference between revisions

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==Overview==
==Overview==
There are no known screening tests for pyelonephritis in normal population. Though pregnancy is an indication for screening for the presence of bacteria in the urine as this may require aggressive treatment because of the associated higher chances of developing pyelonephritis and other complications. Unlike other settings where bacteria are found in the urine of an asymptomatic, non-pregnant woman, bacterial presence in pregnancy should be treated with antibiotics. Urologic surgery and research are other indications for screening patients for asymptomatic bacteriuria.<ref name="pmid26475951">{{cite journal| author=Glaser AP, Schaeffer AJ| title=Urinary Tract Infection and Bacteriuria in Pregnancy. | journal=Urol Clin North Am | year= 2015 | volume= 42 | issue= 4 | pages= 547-60 | pmid=26475951 | doi=10.1016/j.ucl.2015.05.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26475951  }} </ref>
There are no known screening tests for pyelonephritis in general population. However, there are few situations that screening for [[bacteriuria]] is performed. [[Asymptomatic bacteriuria]] must be screened in pregnancy, prior to urologic surgery, and for research purposes.


==Screening==
==Screening==
Screening is recommended to detect bacteriuria during pregnancy. Bacteriuria in pregnancy is always treated unlike asymptomatic non-pregnant population. Careful choice of antibiotics is ensured to prevent adverse effects on the fetus or the mother. Urine culture is done to screen this population for bacterial presence.<ref name="pmid26475951">{{cite journal| author=Glaser AP, Schaeffer AJ| title=Urinary Tract Infection and Bacteriuria in Pregnancy. | journal=Urol Clin North Am | year= 2015 | volume= 42 | issue= 4 | pages= 547-60 | pmid=26475951 | doi=10.1016/j.ucl.2015.05.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26475951  }} </ref><ref name="pmid25861291">{{cite journal| author=Matuszkiewicz-Rowińska J, Małyszko J, Wieliczko M| title=Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems. | journal=Arch Med Sci | year= 2015 | volume= 11 | issue= 1 | pages= 67-77 | pmid=25861291 | doi=10.5114/aoms.2013.39202 | pmc=4379362 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25861291  }} </ref>
There are no known screening tests for pyelonephritis in general population. However, there are few situations that screening for [[bacteriuria]] is performed.


*[[Asymptomatic bacteriuria]] is only screened for in the following circumstances:<ref name="pmid15714408">{{cite journal| author=Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM et al.| title=Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. | journal=Clin Infect Dis | year= 2005 | volume= 40 | issue= 5 | pages= 643-54 | pmid=15714408 | doi=10.1086/427507 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15714408  }} </ref>
*[[Asymptomatic bacteriuria]] is only screened for in the following circumstances:<ref name="pmid15714408">{{cite journal| author=Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM et al.| title=Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. | journal=Clin Infect Dis | year= 2005 | volume= 40 | issue= 5 | pages= 643-54 | pmid=15714408 | doi=10.1086/427507 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15714408  }} </ref>
**Pregnancy
**[[Pregnancy]]
***Bacteriuria in pregnancy is always treated unlike asymptomatic non-pregnant population. Careful choice of antibiotics is ensured to prevent adverse effects on the [[fetus]] or the mother. Urine culture is done to screen this population for bacterial presence.<ref name="pmid26475951">{{cite journal| author=Glaser AP, Schaeffer AJ| title=Urinary Tract Infection and Bacteriuria in Pregnancy. | journal=Urol Clin North Am | year= 2015 | volume= 42 | issue= 4 | pages= 547-60 | pmid=26475951 | doi=10.1016/j.ucl.2015.05.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26475951  }} </ref><ref name="pmid25861291">{{cite journal| author=Matuszkiewicz-Rowińska J, Małyszko J, Wieliczko M| title=Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems. | journal=Arch Med Sci | year= 2015 | volume= 11 | issue= 1 | pages= 67-77 | pmid=25861291 | doi=10.5114/aoms.2013.39202 | pmc=4379362 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25861291  }} </ref>
**Before urologic surgery
**Before urologic surgery
**Research purposes
**Research purposes


* Routine blood cultures for pyelonephritis detection in pregnancy have not been found to be effective.<ref name="pmid25679346">{{cite journal| author=Gomi H, Goto Y, Laopaiboon M, Usui R, Mori R| title=Routine blood cultures in the management of pyelonephritis in pregnancy for improving outcomes. | journal=Cochrane Database Syst Rev | year= 2015 | volume=  | issue= 2 | pages= CD009216 | pmid=25679346 | doi=10.1002/14651858.CD009216.pub2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25679346  }} </ref>
* Routine [[blood cultures]] for pyelonephritis detection in [[pregnancy]] have not been found to be effective.<ref name="pmid25679346">{{cite journal| author=Gomi H, Goto Y, Laopaiboon M, Usui R, Mori R| title=Routine blood cultures in the management of pyelonephritis in pregnancy for improving outcomes. | journal=Cochrane Database Syst Rev | year= 2015 | volume=  | issue= 2 | pages= CD009216 | pmid=25679346 | doi=10.1002/14651858.CD009216.pub2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25679346  }} </ref>


==References==
==References==
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[[Category:Medicine]]
[[Category:Infectious disease]]
[[Category:Nephrology]]
[[Category:Urology]]
[[Category:Up-To-Date]]
[[Category:Emergency medicine]]

Latest revision as of 23:54, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

There are no known screening tests for pyelonephritis in general population. However, there are few situations that screening for bacteriuria is performed. Asymptomatic bacteriuria must be screened in pregnancy, prior to urologic surgery, and for research purposes.

Screening

There are no known screening tests for pyelonephritis in general population. However, there are few situations that screening for bacteriuria is performed.

  • Asymptomatic bacteriuria is only screened for in the following circumstances:[1]
    • Pregnancy
      • Bacteriuria in pregnancy is always treated unlike asymptomatic non-pregnant population. Careful choice of antibiotics is ensured to prevent adverse effects on the fetus or the mother. Urine culture is done to screen this population for bacterial presence.[2][3]
    • Before urologic surgery
    • Research purposes

References

  1. Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM; et al. (2005). "Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults". Clin Infect Dis. 40 (5): 643–54. doi:10.1086/427507. PMID 15714408.
  2. Glaser AP, Schaeffer AJ (2015). "Urinary Tract Infection and Bacteriuria in Pregnancy". Urol Clin North Am. 42 (4): 547–60. doi:10.1016/j.ucl.2015.05.004. PMID 26475951.
  3. Matuszkiewicz-Rowińska J, Małyszko J, Wieliczko M (2015). "Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems". Arch Med Sci. 11 (1): 67–77. doi:10.5114/aoms.2013.39202. PMC 4379362. PMID 25861291.
  4. Gomi H, Goto Y, Laopaiboon M, Usui R, Mori R (2015). "Routine blood cultures in the management of pyelonephritis in pregnancy for improving outcomes". Cochrane Database Syst Rev (2): CD009216. doi:10.1002/14651858.CD009216.pub2. PMID 25679346.

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