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Asymptomatic bacteriuria and urinary tract infections in special patient groups: women with diabetes mellitus and pregnant women

Schneeberger, Carolinea,b; Kazemier, Brenda M.c; Geerlings, Suzanne E.b

Current Opinion in Infectious Diseases: February 2014 - Volume 27 - Issue 1 - p 108–114
doi: 10.1097/QCO.0000000000000028
URINARY TRACT INFECTIONS: Edited by Suzanne E. Geerlings
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Purpose of review Asymptomatic bacteriuria (ASB) and urinary tract infections (UTIs) in women with diabetes mellitus and during pregnancy are common and can have far-reaching consequences for the woman and neonate. This review describes epidemiology, risk factors, complications and treatment of UTI and ASB according to recent developments in these two groups.

Recent findings Most articles addressing the epidemiology and risk factors of ASB and UTI in diabetic and pregnant women confirmed existing knowledge. New insights were obtained in the association between sodium–glucose cotransporter-2 (SGLT2) inhibitors, as medication for diabetes mellitus type 2, and a small increased risk for UTI due to glucosuria and the possible negative effects of UTI, including urosepsis,on bladder and kidney function in diabetic women. Predominantly, potential long-term effects of antibiotic treatment of ASB or UTI during pregnancy on the neonate have received attention, including antibiotic resistance and epilepsy.

Summary SGLT2 inhibitors were associated with a small increased risk for UTI, UTI in diabetic women may lead to bladder and kidney dysfunction, and antibiotic treatment of ASB and UTI during pregnancy was associated with long-term effects on the neonate. Up-to-date research on the effectiveness and long-term effects of ASB screening and treatment policies, including group B Streptococcus bacteriuria in pregnancy, is warranted to inform clinical practice.

aDepartment of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, Amsterdam

bDepartment of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen

cDepartment of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, the Netherlands

Correspondence to Caroline Schneeberger, Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, Room F4-106, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Tel: +31612388308; fax: +31 20 697 22 86; e-mail: carolineschneeberger@gmail.com

© 2014 Lippincott Williams & Wilkins, Inc.