Eur J Intern Med. 2026 Mar 23:106813. doi: 10.1016/j.ejim.2026.106813. Online ahead of print.
ABSTRACT
BACKGROUND: Antibiotic treatment for asymptomatic bacteriuria (AB) is not recommended in the general population, and its significance in oncohematological patients remains unclear.
OBJECTIVES: This study aimed to determine the prevalence of AB in hematologic patients and assess the frequency of bacteremia caused by the same microorganism isolated in untreated baseline asymptomatic bacteriuria (Baseline-AB) during myelosuppression.
METHODS: A prospective, observational study was conducted from 2012-2017 in adult patients admitted for chemotherapy. Urine cultures (UCs) were performed, and no prophylactic antibiotics were administered. Blood and UC samples were collected during episodes of febrile neutropenia (FN) before antibiotic administration and compared with baseline UC results.
RESULTS: Among 121 patients, 167 FN episodes were recorded, with 19 (11.3%) having Baseline-AB. A urinary focus was found in 1/19 (5.2%) of the Baseline-AB episodes, compared to 9/148 (6%) of the non baseline-AB (No-Baseline-AB) episodes (OR: 0.86; 95% CI:0.10-7.17;p = 0.88). Bacteremia occurred in 4/19 (21%) of the Baseline-AB episodes and in 38/148 (25.6%) of the No-Baseline-AB episodes. Only 1/19 patients in the Baseline-AB group (5.2%) had bacteremia caused by the same microorganism identified in the baseline UC.
OUTCOME: FN resolved in all Baseline-ABs and in 96.6% of No-Baseline-ABs. Overall mortality occurred in 9/121 (7.4%) patients.
CONCLUSION: Baseline-ABs were present in more than 10% of episodes, but no correlation was found between Baseline-ABs and bacteremia during FN. Only one case showed the same pathogen in both the baseline UC and the blood culture, suggesting that routine antibiotic treatment for Baseline-AB may not be necessary in this population.
PMID:41876326 | DOI:10.1016/j.ejim.2026.106813
