Most people know when they have a urinary tract infection, or UTI. They experience burning when they urinate and the need to go more frequently. Even though there’s a constant urge to void, very little comes out – and what does come out stings. Some people even notice blood in their urine and have abdominal and back discomfort when they have a UTI. But is this always the case? Can you have an UTI without symptoms – and should you treat it if it’s asymptomatic?
Can You Have a UTI with No Symptoms?
It’s not uncommon to have a urinary tract infection without symptoms. Certain groups of people are more likely to have a UTI without symptoms. Older folks and women who are pregnant are two groups at higher risk for an asymptomatic urinary tract infection. Elderly people who are frail or have a catheter, such as people in nursing homes, are at especially high risk for asymptomatic urinary tract infections.
About one out of five women over the age of 65 not living in an institutionalized setting has enough bacteria in their urine to be classified as a UTI, but they don’t have symptoms. About one out of ten men do too. The numbers rise to as high as 40-50% of all men and women in long-term care facilities.
The diagnosis of UTI without symptoms is usually made based on having a certain number of bacteria in the urine, but care must be taken when collecting the urine to ensure that there isn’t contamination. Urine should preferably be obtained by the clean-catch method and collected mid-stream.
Does a UTI without Symptoms Need to Be Treated?
According to the Infectious Diseases Society of America, a UTI with no symptoms doesn’t require treatment. This is because most asymptomatic urinary tract infections don’t become symptomatic, and the risks of taking antibiotics to kill the bacteria outweigh the benefits. In people who can’t easily communicate their symptoms, such as those in long-term care facilities, doctors look for other signs such as fever or a positive blood culture to justify treatment of a urinary tract infection.
There are a few exceptions to this rule. Women who are pregnant and have bacteria in their urine need prompt treatment as they run the risk of developing a more serious kidney infection later in their pregnancy if they aren’t treated. People who have kidney stones and bacteria in their urine, and those undergoing surgery on any part of their urinary tract would also need treatment for a UTI with no symptoms.
The Bottom Line?
In most cases, bacteria in the urine that isn’t causing symptoms doesn’t need treatment except in pregnant women and people with kidney stones or who are undergoing surgery on their urinary tract. Most bacteria in the urine that isn’t causing symptoms don’t cause problems.
References:
Medscape.com. “Urinary Tract Infections in Older Adults”
Merck Manual. Eighteenth edition. 2006.
