A case-control study of purple urine bag syndrome in geriatric wards

Mantani, Naoki; Kogure, Toshiaki; Ochiai, Hiroshi; Imanishi, Nobuko; Terasawa, Katsutoshi; Tamura, Jun’ichi

doi:10.1007/s10156-002-0210-x

Cited by 60 publications

(73 citation statements)

References 9 publications

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“…No associations were found between other variables that the literature describes as risk factors for PUBS. However, our patient had other risk factors for PUBS including alkaline urine and the presence of bacteria in urine [5,11,14].…”

Section: Discussionmentioning

confidence: 78%

“…Although the presence of polymicrobial infection in UTIs can be considered as contamination, the microbiological criteria for determination of contamination versus true bacteriuria is arbitrary and a common criterion for defining significant bacteriuria is a colony count ≥ 10 4 CFU/mL [21]. It is important to remark that mixed infections of the urinary tract with high bacterial counts are common in patients with PUBS [5].…”

Section: Discussionmentioning

confidence: 99%

“…This syndrome has been described mostly in elderly women with diseases that cause some degree of gastrointestinal stasis (usually bedridden) and have long-term urinary catheters in the presence of a urinary tract infection and alkaline urine [4][5][6][7][8]. Different studies have reported that the prevalence of this condition in people with indwelling urinary catheter varies from 8.3% to 42.1% [5,[7][8][9].…”

Section: Pubsmentioning

confidence: 99%

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Purple urine bag syndrome in an elderly patient from Colombia

Mondragón-Cardona

Jiménez-Cañizales

Alzate-Carvajal

et al. 2015

J Infect Dev Ctries

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A 71-year-old woman in a nursing home, with indwelling urinary catheter, bedridden, presented with a purple urine collector bag. The purple urine bag syndrome is a rare condition associated with the metabolism of tryptophan by overgrowth of intestinal bacteria. The purple color is formed by a combination of indigo and indirubin produced as a result of phosphatase and sulfatase enzymatic activity of bacteria on indoxyl sulfate, under alkaline pH of the urine. We present the second case of this syndrome reported in Colombia detailing the management of this rare syndrome associated with urinary tract infection. Several conditions should be considered in the differential diagnose of diseases that cause discoloration of the urine.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Pubsmentioning

confidence: 99%

See 1 more Smart Citation

Purple urine bag syndrome in an elderly patient from Colombia

Mondragón-Cardona

Jiménez-Cañizales

Alzate-Carvajal

et al. 2015

J Infect Dev Ctries

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“…Purple urine bag syndrome actually is not very rare, especially in chronically debilitated patients and in elderly patients who also tend to have several comorbidities (1,2). PUBS is essentially harmless, although it can be alarming to both patients and doctor.…”

mentioning

confidence: 99%

Purple Urine Bag Syndrome in a Male Patient with Chronic Hemodialysis

et al. 2016

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A 78-year-old male patient who had an indwelling urinary catheter because of benign hyperplasia of the prostate and who had been receiving hemodialysis twice a week due to endstage renal disease was admitted to our hospital complaining of three days of purple urine color (Figure 1). His medications included beta blocker, anti-aggregant, erythropoietin, piracetam and calcitriol therapies. A urine analysis was performed; the results were as follows: pH: 8.0, density: 1012, leukocyte esterase: (++), leukocyte: 11/HPF (high power field), erythrocyte: 4/HPF and nitrite: negative. The diagnosis of purple urine bag syndrome (PUBS) was made. Treatment with ceftriaxone 2 g/day intravenously (IV) was started immediately on an empirical basis, and the catheter was replaced. Extendedspectrum beta-lactamase-positive Escherichia coli was isolated in urine culture, and the antibiotherapy was changed to imipenem/cilastatin 250 mg IV twice daily. On the fifth day of treatment, the patient's urine color returned to normal, and a urine sample was negative for leukocyte esterase.Discoloration of urine is important in clinical diagnosis and treatment. PUBS stands for purple discoloration of the urine occurring in patients with long-term urinary catheterization. The interesting point of this syndrome is that the urine itself is unchanged in color but the only change in color is within the bag itself. Reported risk factors of PUBS include chronic urinary catheterization, old age, female gender, dehydration, bedridden, constipation, advanced chronic kidney disease, alkaline or acidic urine, and PVC catheters and bags (1-3). Briefly, pathogenesis is related to sulfatase and/or phosphatase enzyme carrying bacteria (such as Klebsiella, E. Coli, Morganella, Pseudomonas, Enterobacter, Proteus) (1) that leads to metabolize indican into indigo (blue pigment) and indirubin (red pigment) in the urine which results purple discoloration of urine in the plastic of the urine bag (4).

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“…Los factores de riesgo para presentar PUBS son el sexo femenino, la edad avanzada, el uso de catéter urinario permanente, la postración, la constipación crónica, la enfermedad renal crónica y la dieta hiperproteica, factores que se relacionan con la disminución del tránsito intestinal, sobrecrecimiento bacteriano y aumento de la cantidad de indol en el intestino [4][5][6][7] .…”

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Síndrome de la bolsa de orina púrpura: un fenómeno inusual y muy llamativo

2014

Rev. méd. Chile

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A case-control study of purple urine bag syndrome in geriatric wards

Cited by 60 publications

References 9 publications

Purple urine bag syndrome in an elderly patient from Colombia

Purple urine bag syndrome in an elderly patient from Colombia

Purple Urine Bag Syndrome in a Male Patient with Chronic Hemodialysis

Síndrome de la bolsa de orina púrpura: un fenómeno inusual y muy llamativo

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