**7. Asymptomatic bacteriuria**

Asymptomatic bacteriuria is defined as the presence of a significant number of urine microbes (105 CFU/ml) in patients without clinical symptoms or signs of infection. The incidence varies depending on the age of the patients, the sex and the presence or absence of functional or anatomical urinary tract abnormalities. Bladder catheterization is the most important predisposing factor for asymptomatic microbial growth. In hospitalized catheterized patients with an open urine collection system, the incidence of the asymptomatic microbial disease is 100% of the patients within 3–4 days.

Microorganisms most commonly isolated in bladder catheterized patients are *Escherichia coli*, Klebsiella, Proteus, Enterococcus, Enterobacter, Pseudomonas, Serratia, and Candida. Most are part of the microbial flora of the bowel colonizing the anterior part of the urethra. In patients with a bladder catheter for a short or long period of time, urine specimen collection should be taken by catheter puncture after meticulous antisepsis of the puncture site and not through the catheter's mouth. The presence of leucocytes with or without hematuria is taken into account but does not necessarily require the diagnosis of active infection. Asymptomatic bacteriuria in individuals with SCI requires treatment only in cases where symptomatic urinary tract infection develops [76, 77].
