***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Asymptomatic bacteriuria is common in young women , but little is known about its pathogenesis , natural history , risk factors , and temporal association with symptomatic urinary tract infection . METHODS We prospect ively evaluated 796 sexually active , nonpregnant women from 18 through 40 years of age over a period of six months for the occurrence of asymptomatic bacteriuria ( defined as at least 10(5 ) colony-forming units of urinary tract pathogens per milliliter ) . The women were patients at either a university student health center or a health maintenance organization . Periodic urine cultures were taken , daily diaries were kept , and regularly scheduled interviews were performed . Escherichia coli strains were tested for hemolysin , the papG genotype , and the ribosomal RNA type . RESULTS The prevalence of asymptomatic bacteriuria ( the proportion of urine cultures with bacteriuria in asymptomatic women ) was 5 percent ( 95 percent confidence interval , 4 percent to 6 percent ) among women in the university group and 6 percent ( 95 percent confidence interval , 5 percent to 8 percent ) among women in the health-maintenance-organization group . Persistent asymptomatic bacteriuria with the same E. coli strain was rare . Symptomatic urinary tract infection developed within one week after 8 percent of occasions on which a culture showed asymptomatic bacteriuria , as compared with 1 percent of occasions when asymptomatic bacteriuria was not found ( P<0.001 ) . Asymptomatic bacteriuria was associated with the same risk factors as for symptomatic urinary tract infection , particularly the use of a diaphragm plus spermicide and sexual intercourse . CONCLUSIONS Asymptomatic bacteriuria in young women is common but rarely persists . It is a strong predictor of subsequent symptomatic urinary tract infection Importance Screening for asymptomatic bacteriuria can identify patients for whom treatment might be beneficial for preventing symptomatic infection and other health outcomes . Objective To systematic ally review benefits and harms of  asymptomatic bacteriuria screening and treatment in adults , including during pregnancy , to inform the US Preventive Services Task Force . Data Sources MEDLINE , PubMed ( publisher-supplied records ) , and Cochrane Collaboration Central Registry of Controlled Trials ; surveillance through May 24 , 2019 . Study Selection R and omized clinical trials ( RCTs ) and observational studies on benefits and harms of screening for asymptomatic bacteriuria ; RCTs on benefits and harms of asymptomatic bacteriuria treatment .  Eligible population s included unselected , asymptomatic individuals without known urinary tract conditions . Data Extraction and Synthesis Independent critical appraisal and data abstract ion by 2 review ers . R and om-effects meta- analysis was conducted to estimate benefits of the interventions . Main Outcomes and Measures Symptomatic infection ; function , morbidity , mortality ; pregnancy complications and birth outcomes . Results Nineteen studies ( N = 8443 ) meeting inclusion criteria were identified . Two cohort studies ( n = 5289 ) found fewer cases of pyelonephritis in the cohorts of screened pregnant women ( 0.5 % ) than within retrospective comparisons of unscreened cohorts ( 2.2 % and 1.8 % ) ; the larger study estimated a statistically significant relative risk of 0.30 ( 95 % CI , 0.15 - 0.60 ) . No studies examined screening in nonpregnant population s. Among 12 trials of asymptomatic bacteriuria screening and treatment during pregnancy ( n = 2377 ; 1 conducted within past 30 years ) , there were reduced rates of pyelonephritis ( range , 0%-16.5 % for the intervention group and 2.2%-36.4 % for the control group ; pooled risk ratio [ RR ] , 0.24 [ 95 % CI , 0.14 - 0.40 ] ; 12 trials ) and low birth weight ( range , 2.5%-14.8 % for the intervention group and 6.7%-21.4 % for the control group ; pooled RR , 0.64 [ 95 % CI , 0.46 - 0.90 ] ; 7 trials ) . There was no significant difference in infant mortality ( pooled RR , 0.98 [ 95 % CI , 0.29 - 3.26 ] ; 6 trials ) . Five RCTs of asymptomatic bacteriuria treatment in nonpregnant adults ( n = 777 ) did not report any significant differences in risk of infection , mobility , or mortality . Limited evidence on harms of screening or treatment was available , and no statistically significant differences were identified . Conclusions and Relevance Screening and treatment for asymptomatic bacteriuria during pregnancy was associated with reduced rates of pyelonephritis and low birth weights , but the available evidence was not current , with only 1 study conducted in the past 30 years . Benefits of asymptomatic bacteriuria treatment in nonpregnant adult population s were not found . Trial evidence on harms of asymptomatic bacteriuria antibiotic treatment was limited 
    Output:
    
More recently , increasing attention to the importance of the human microbiome , and the suggestion that antimicrobial therapy may have deleterious effects on the microbiome influencing both short and long-term health status for both noninfectious and infectious diseases , has reinforced concerns about antimicrobial use.6 Inappropriate antimicrobial treatment of asymptomatic bacteriuria is well documented,4,7 and the implementation of programs to discourage treatment of asymptomatic bacteriuria is an important facet of antimicrobial stewardship initiatives.8 For this USPSTF up date , there was no new evidence to inform the question of screening or treating asymptomatic bacteriuria for healthy , nonpregnant women .
For these women , asymptomatic bacteriuria with the same or different bacterial strains may persist for months or years.10 Symptomatic urinary tract infection occurs more frequently in women with asymptomatic bacteriuria , but asymptomatic bacteriuria does not cause symptomatic infection , and there is no evidence for other harms with asymptomatic bacteriuria .