Effect of cranberry juice on bacteriuria in children with neurogenic bladder receiving intermittent catheterization

Schlager, Theresa A.; Anderson, Susan; Trudell, Julie; Hendley, J. Owen

doi:10.1016/s0022-3476(99)70087-9

Cited by 102 publications

(56 citation statements)

References 11 publications

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“…2,5 Two crossover studies in children with neurogenic bladder found no difference in either UTI or in bacteriuria with the use of cranberry juice, for either 3 or 6 months. 3,4 The natural history of UTI in congenital neurogenic bladder may not be the same as that of adult onset, or cranberry extract may not be effective for preventing bacterial colonization in that population. It is also conceivable that the dosage was inadequate for children.…”

Section: Discussionmentioning

confidence: 99%

“…Adult women with recurrent UTI appeared to receive a significant benefit, but children with neurogenic bladder did not. [1][2][3][4][5] The adult spinal cord injured (SCI) population are at high-risk for UTI, with estimates as high as 1.8 episodes per year. 6 Infections are often polymicrobial and antibiotic resistant, and long-term antibiotic prophylaxis has not shown significant benefit.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder

et al. 2008

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Study Design: Randomized, double blind, placebo-controlled trial with a crossover design. Objective: To evaluate cranberry tablets for the prevention of urinary tract infection (UTI) in spinal cord injured (SCI) patients. Setting: Spinal Cord Injury Unit of a Veterans Administration Hospital, MA, USA. Methods: Subjects with spinal cord injury and documentation of neurogenic bladder were randomized to receive 6 months of cranberry extract tablet or placebo, followed by the alternate preparation for an additional 6 months. The primary outcome was the incidence of UTI. Results: Forty-seven subjects completed the trial. We found a reduction in the likelihood of UTI and symptoms for any month while receiving the cranberry tablet (Po0.05 for all). During the cranberry period, 6 subjects had 7 UTI, compared with 16 subjects and 21 UTI in the placebo period (Po0.05 for both number of subjects and incidence). The frequency of UTI was reduced to 0.3 UTI per year vs 1.0 UTI per year while receiving placebo. Subjects with a glomerular filtration rate (GFR) greater than 75 ml min À1 received the most benefit. Conclusion: Cranberry extract tablets should be considered for the prevention of UTI in SCI patients with neurogenic bladder. Patients with a high GFR may receive the most benefit.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder

et al. 2008

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“…The coupling constant between H-2″ and H-3″ differed markedly from 15.9 Hz in 1 to 12.6 Hz in 2. Comparing the 13 C NMR spectra, the chemical shift of C-2″ was shifted downfield from δ C 114.89 in 1 to 116.89 in 2, while the chemical shift of C-3″ moved to higher field from δ C 147.03 in 1 to 144.32 in 2. This evidence indicated that compound 2 had a cis-coumaroyl substituent, as opposed to the trans-coumaroyl seen in 1.…”

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confidence: 93%

Coumaroyl Iridoids and a Depside from Cranberry (Vaccinium macrocarpon)

et al. 2007

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Cranberry (Vaccinium macrocarpon Ait., Ericaceae) juice has been used for urinary tract infections for approximately 50 years. Recent research suggests that this botanical blocks adherence of pathogenic E. coli to urinary tract cells, thus preventing infection. While current evidence indicates that proanthocyanidins are responsible for this activity, these compounds may not reach the urinary tract, thus further investigation is warranted. Fractionation of cranberry juice concentrate was guided by a recently published antiadherence assay, and the resulting fractions were phytochemically characterized. Two new coumaroyl iridoid glycosides, 10-p-trans-(1) and 10-p-cis-coumaroyl-1S-dihydromonotropein (2), and a depside, 2-O-(3,4-dihydroxybenzoyl)-2,4,6-trihydroxyphenylmethylacetate (3) were isolated, and although these compounds did not have antiadherent activity in isolation, they might constitute a new group of marker compounds for this active fraction of cranberry.Cranberry (Vaccinium macrocarpon Ait., Ericaceae) juice, generally in the form of cranberry juice cocktail consisting of a mixture of cranberry juice, water and sugar, is a popular botanical dietary supplement 1, 2 primarily used for the treatment and prevention of urinary tract infections, with documented human use for at least 47 years. 3 This use is supported by several clinical trials, 4-11 although some trials, notably for children with neuropathic bladder and catheterization, did not find cranberry to be effective. 12, 13 Cranberry juice was originally believed to be active due to its acidifying effect on urine, and/or the increased excretion of the cranberry urinary metabolite hippuric acid. 14, 15 However, subsequent research suggested that the bacteriostatic impact from acidification alone could not account for its demonstrated effects. 16,17 Inhibition of adherence of Escherichia coli to uroepithelial cells, 18-20 rather than direct bacteriostatic or bactericidal activity, has been proposed as the mechanism of action. Specifically, there is support for inhibition of the papG fimbrial attachment of uropathogenic strains of E. coli to human cells 21, 22 by cranberry's A-type proanthocyanidin compounds, but not by a B-type dimer or the (-)-epicatechin monomer. 18, 23 Proanthocyanidins, however, may not be assimilated in the gut, nor reach the urinary tract intact. 24 The putative active cranberry A-type proanthocyanidin oligomers, containing a second link (carbon-oxygen) between at least two of their epicatechin monomer units, are chemically similar to B-type proanthocyanidins, which contain only single, carbon-carbon links between units. Knowledge *To whom correspondence should be addressed. Tel: 312-355-1949. Fax: 312-355-2693. E-mail: gfp@uic.edu. † Equally contributing authors Supporting Information. HPLC chromatograms of the two lots of cranberry juice used in this research, including retention time for known cranberry compounds ideain chloride, resveratrol, and benzoic acid, are available free of charge via the Internet at http://pu...

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“…[10][11][12][13][14][15][16][17] The results from some, but not all, of these trials suggest that cranberry may reduce the incidence of bacteriuria and UTI, particularly in healthy women with acute, uncomplicated cystitis. 6 In 2003, the National Center for Complementary and Alternative Medicine provided a standardized, well-characterized cranberry juice cocktail and matching placebo juice for conduct of studies that evaluated potential health benefits of cranberry products.…”

mentioning

confidence: 99%

Recurrent Urinary Tract Infection and Urinary Escherichia coli in Women Ingesting Cranberry Juice Daily: A Randomized Controlled Trial

Stapleton

Dziura

Hooton

et al. 2012

Mayo Clinic Proceedings

112

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Objective: To compare the time to urinary tract infection (UTI) and the rates of asymptomatic bacteriuria and urinary P-fimbriated Escherichia coli during a 6-month period in women ingesting cranberry vs placebo juice daily. Patients and Methods: Premenopausal women with a history of recent UTI were enrolled from November 16, 2005, through December 31, 2008, at 2 centers and randomized to 1 of 3 arms: 4 oz of cranberry juice daily, 8 oz of cranberry juice daily, or placebo juice. Time to UTI (symptoms plus pyuria) was the main outcome. Asymptomatic bacteriuria, adherence, and adverse effects were assessed at monthly visits. Results: A total of 176 participants were randomized (120 to cranberry juice and 56 to placebo) and followed up for a median of 168 days. The cumulative rate of UTI was 0.29 in the cranberry juice group and 0.37 in the placebo group (Pϭ.82). The adjusted hazard ratio for UTI in the cranberry juice group vs the placebo group was 0.68 (95% confidence interval, 0.33-1.39; Pϭ.29). The proportion of women with P-fimbriated urinary E coli isolates during the intervention phase was 10 of 23 (43.5%) in the cranberry juice group and 8 of 10 (80.0%) in the placebo group (Pϭ.07). The mean dose adherence was 91.8% and 90.3% in the cranberry juice group vs the placebo group. Minor adverse effects were reported by 24.2% of those in the cranberry juice group and 12.5% in the placebo group (Pϭ.07). Conclusion: Cranberry juice did not significantly reduce UTI risk compared with placebo. The potential protective effect we observed is consistent with previous studies and warrants confirmation in larger, well-powered studies of women with recurrent UTI. The concurrent reduction in urinary P-fimbriated E coli strains supports the biological plausibility of cranberry activity.

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Effect of cranberry juice on bacteriuria in children with neurogenic bladder receiving intermittent catheterization

Cited by 102 publications

References 11 publications

Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder

Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder

Coumaroyl Iridoids and a Depside from Cranberry (Vaccinium macrocarpon)

Recurrent Urinary Tract Infection and Urinary Escherichia coli in Women Ingesting Cranberry Juice Daily: A Randomized Controlled Trial

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