Bacteriuria asintomática en mujeres diabéticas: revisión sistemática

BACKGROUND AND OBJECTIVES: Urinary tract infection (UTI) is a common disease and, in the absence of symptoms, is called asymptomatic bacteriuria (AB). The management of BA in diabetic female patients is controversial. The aim of this study was to discuss findings in literature that are related to AB in diabetic women and to management of this condition.CONTENTS: A systematic review of the literature in Medline, LILACS and Scielo in the period from 1997 to 2012, using descriptors such as "asymptomatic bacterinuria and diabetes" was performed. The prevalence of AB is three times greater in diabetic than in non-diabetic women. Several risk factors for AB in women with diabetes have been suggested, such as age; sexual intercourse and disease duration. The most often found bacteria in AB is Escherichia coli. Cohort studies with longer follow-up did not show that AB could lead to loss of renal function and/or hypertension when they compared groups of diabetic women with and without AB. Regarding the incidence of new UTI episodes, clinical trials showed no differences when compared AB group treated with antibiotics versus AB group treated with placebo. Also, there was no significant difference with the occurrence of more resistant bacteria as a cause of new UTI. CONCLUSION: The treatment of AB does not decrease the number of episodes of symptomatic UTI, acute pyelonephritis, and hospitalization in diabetic women in the long run. For this reason, screening and treatment of AB in diabetic women should not be recommended.