Understanding the difference between bacteriuria and a urinary tract infection

October 13, 2017 Kaitlyn Matousek


More than 20% of women over 80 years old have bacteria present in their urine—but that isn't always a bad thing. Find out why bacteriuria isn't always a cause for concern. 

Is Bacteriuria the same as a Urinary Tract Infection? 

From the day we are born our bodies are constantly changing, adapting throughout our entire life. Although UTIs are an ever-present topic in most women's lives, the role bacteria places in your urinary tract can also shift over time. Women post-menopause are more likely to develop a UTI than women pre-menopause, and more than 20% of women over 80 have asymptomatic bacteriuria. While, on the surface, bacteriuria sounds a lot like a UTI, it can actually be quite different.

Urine is normally sterile, but asymptomatic bacteriuria is when bacteria is present in the urine with no infection or inflammation present. This condition becomes more common with age because it is related to changes in the immune system. 

Asymptomatic bacteriuria and UTIs will both produce a positive urine culture and it is very common for seniors to inappropriately be given antibiotics. UTIs are most commonly treated with antibiotics, but treating asymptomatic bacteriuria with antibiotics has been linked to negative health effects like yeast infections and an increased risk of UTIs. Treating patients with antibiotics when there is no evidence of a bacterial infection can lead to drug resistance—the process in which bacteria become resistant to antibiotics causing antibiotics to lose their effectiveness. That’s why it is so important to know if you have a UTI or asymptomatic bacteriuria.

So how can you tell if it's a UTI or bacteriuria?

With a UTI, you'll most likely notice the following symptoms: 

  • Burning/irritation with urination
  • Increased urgency or frequency in urination
  • Blood in urine
  • Pain with urination
  • Fever
  • Confusion

If you do not experience any UTI symptoms then you most likely have asymptomatic bacteriuria, which should not be treated with antibiotics. However, there are a few scenarios in which you should consider treating asymptomatic bacteriuria:

  • You are pregnant
  • You are undergoing surgery on your bladder or other organs in your urinary tract
  • You have a kidney stone

It’s important to remember elderly people do not always exhibit classic UTI symptoms and instead show signs of Alzheimer's or dementia-like confusion, falling and irritability. If an elderly person has a positive urine sample and shows signs of dementia that have not previously shown, they could very well have a UTI. That’s is why it vital to ask your medical care providers the right questions to make sure you/your loved ones are receiving appropriate treatment.

Good tips to avoid both UTIs and asymptomatic bacteriuria

  • Drink plenty of water
  • Urinate regularly during the day and empty your bladder fully every time
  • Wipe from front to back
  • Wear loose clean cotton underwear
  • Drink Uqora daily  

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