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.
Written by:
Schneeberger C, Kazemier BM, Geerlings SE. Are you the author?
Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, Amsterdam; Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen; Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands.
Reference: Curr Opin Infect Dis. 2014 Feb;27(1):108-14.
doi: 10.1097/QCO.0000000000000028
PubMed Abstract
PMID: 24296584
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