Clinical microbiology and hospital infection control: asymptomatic bacteriuria: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · Clinical microbiology and hospital infection control: asymptomatic bacteriuria

Sample item

A 70-year-old woman with a long-term indwelling urinary catheter has no fever or urinary symptoms. A routine urine culture grows more than 100,000 CFU/mL of Escherichia coli with pyuria. What is the appropriate action?

ARemove the catheter and give intravenous ceftriaxoneBStart long-term prophylactic ciprofloxacinCStart oral nitrofurantoin for seven daysDNo antibiotics unless symptoms or special indications arise

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. No antibiotics unless symptoms or special indications arise

Bacteriuria with pyuria is universal in long-term catheterised patients and does not need treatment in the absence of symptoms. Exceptions are pregnancy and before urologic procedures with mucosal bleeding. Treating it promotes resistance.

Option by option

A. Remove the catheter and give intravenous ceftriaxone
IV ceftriaxone is excessive for a patient without symptoms.
B. Start long-term prophylactic ciprofloxacin
Prophylaxis with ciprofloxacin drives resistance and does not prevent bacteriuria.
C. Start oral nitrofurantoin for seven days
Nitrofurantoin would treat a colonisation and select for resistance.
D. No antibiotics unless symptoms or special indications arise (correct)
Correct. Asymptomatic bacteriuria in a catheterised patient should not be treated.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is D, No antibiotics unless symptoms or special indications arise. Bacteriuria with pyuria is universal in long-term catheterised patients and does not need treatment in the absence of symptoms.

Why is "Remove the catheter and give intravenous ceftriaxone" not the answer?

IV ceftriaxone is excessive for a patient without symptoms.

Why is "Start long-term prophylactic ciprofloxacin" not the answer?

Prophylaxis with ciprofloxacin drives resistance and does not prevent bacteriuria.

Why is "Start oral nitrofurantoin for seven days" not the answer?

Nitrofurantoin would treat a colonisation and select for resistance.

What concept does this question test?

It tests Clinical microbiology and hospital infection control: asymptomatic bacteriuria in Microbiology. Exceptions are pregnancy and before urologic procedures with mucosal bleeding. Treating it promotes resistance.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Clinical microbiology and hospital infection control: asymptomatic bacteriuria?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.