scholarly journals Purple Urine Bag Syndrome: Uncommon Clinical Entity Associated with Common Infection, Case Report

2020 ◽  
Vol 35 (3) ◽  
pp. 205-211
Author(s):  
Muftah H. Elkhafifi
Keyword(s):  
Urinary Tract ◽  
Elderly Women ◽  
Bacterial Load ◽  
Female Gender ◽  
Purple Urine Bag Syndrome ◽  
Polyvinyl Chloride Plastic ◽  
Indigo Blue ◽  
Tract Infections ◽  
Purple Urine ◽  
Common Infection

 Purple urine bag syndrome (PUBS) is a rare medical syndrome where purple discoloration of urine occurs predominantly in chronically constipated bedridden elderly women, chronically catheterized and associated with   urinary tract infections (UTIs). The etiology is related to UTIs with specific bacteria that produce sulphatase and phosphatase enzymes which lead tryptophan metabolism to produce two pigments: Indigo (blue) and indirubin (red), mixtures of which become purple in color. Several risk factors are associated with PUBS; including female gender, increased dietary tryptophan, alkaline urine, constipation, catheterization, high urinary bacterial load, renal failure and use of polyvinyl chloride plastic catheters. Herein, I present this rare benign interesting condition on a 78 years old lady with purple discoloration of her urine bag due to urinary tract infection caused by Escherichia coli that was successfully treated by culture guided antibiotic (Ciprofloxacin). The purple urine disappeared after antibiotic therapy and change of the urine catheter and bag.

scholarly journals Purple Urine Bag Syndrome: A Rare Spot Diagnosis

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Dilraj S. Kalsi ◽  
Joel Ward ◽  
Regent Lee ◽  
Ashok Handa
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Disease Management ◽  
Renal Disease ◽  
Female Gender ◽  
High Morbidity ◽  
Purple Urine Bag Syndrome ◽  
Indigo Blue ◽  
Tract Infections ◽  
Purple Urine

Purple urine bag syndrome (PUBS) is a complication of urinary tract infections (UTIs) where catheter bags and tubing turn purple. It is alarming for patients, families, and clinicians; however, it is in itself a benign phenomenon. PUBS is the result of UTIs with specific bacteria that produce sulphatases and phosphatases which lead tryptophan metabolism to produce indigo (blue) and indirubin (red) pigments, a mixture of which becomes purple. Risk factors include female gender, immobility, constipation, chronic catheterisation, and renal disease. Management involves reassurance, antibiotics, and regular changing of catheters, although there are debates regarding how aggressively to treat and no official guidelines. Prognosis is good, but PUBS is associated with high morbidity and mortality due to the backgrounds of patients. Here, we review the literature available on PUBS, present a summary of case studies from the last five years, and propose the Oxford Urine Chart as a tool to aid such diagnoses.

Purple urine bag syndrome: When the urine turns purple – An under diagnosed spot diagnosis

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Cathrin Kodde ◽  
◽  
Till Othmer ◽  
David Krieger ◽  
Silke Polsfuss ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antibiotic Therapy ◽  
Urinary Catheter ◽  
Rare Condition ◽  
Community Acquired Pneumonia ◽  
Purple Urine Bag Syndrome ◽  
Indigo Blue ◽  
Tract Infections ◽  
Purple Urine

The Purple Urine Bag Syndrome (PUBS) is a rare condition in which the urine turns purple. It may occur in Urinary Tract Infections (UTIs) when bacteria metabolize dietary tryptophan to indole resulting in indigo (blue) and indirubin (red). This condition is mostly seen in elderly female patients with permanent urinary bladder catheterization. Patients, relatives and health professionals may be concerned about this discolouration, which is usually harmless. Medical management of PUBS involves frequent urinary bag change, antibiotic therapy and most importantly reassurance. We report an 89-years-old long-term catheterized female nursing home resident who was admitted to the emergency room because of a Community Acquired Pneumonia (CAP). After a few days of inpatient treatment her urine bag turned purple. Antibiotic therapy continued and the indwelling urinary catheter was changed resulting in clear urine. Keywords: Purple urine bag syndrome (PUBS); purple discolouration; urinary tract infection (UTI); long-term catheterization.

scholarly journals Purple Urine Bag Syndrome: More Than Eyes Can See

2019 ◽  
Vol 13 (3) ◽  
pp. 125-132 ◽  
Author(s):  
Nikos Sabanis ◽  
Eleni Paschou ◽  
Panagiota Papanikolaou ◽  
Georgios Zagkotsis
Keyword(s):  
Chronic Kidney Disease ◽  
Urinary Tract ◽  
Kidney Disease ◽  
Urinary Tract Infections ◽  
Predisposing Factors ◽  
Recruitment Strategy ◽  
Purple Urine Bag Syndrome ◽  
Tract Infections ◽  
Purple Urine

Background/Aims: Purple urine bag syndrome (PUBS) is an uncommon clinical entity characterized by purple urine discoloration in the setting of urinary tract infections. Pa-thophysiology of PUBS has been correlated to aberrant metabolism of tryptophan. Multiple predisposing factors have been recognized, namely: female gender, advanced age, constipation, institutionalization, long-term catheter-ization, dementia and chronic kidney disease. Herein, we present a comprehensive review of all PUBS cases reported in PubMed, focusing on the predisposing factors and the microorganisms related to PUBS. Methods: We performed a search in PubMed database for articles referring to PUBS, published in English, French, Spanish and German from January 1978 until November 2017. The literature recruitment strategy was based on several keywords and Medical Subject Heading combination such as “purple urine bag syndrome” or PUBS or “urine discoloration”. The finally selected articles were categorized into case reports/series (88 articles including 112 patients) and studies (10 articles including 134 patients). Demographical data as well as predisposing factors were recorded and further analyzed. Results: According to our findings, mean age of PUBS patients was 78.9 ± 12.3 years, 70.7% were female while 90.1% were suffering from constipation, 76.1% were in a bedridden situation, 45.1% were experiencing long-term catheterization, 42.8% had been diagnosed with dementia, 14.3% had recurrent urinary tract infections and 14.1% were chronic kidney disease patients. 91.3% of patients presenting with PUBS alkaline urine were observed while the most common microbe in urine cultures was E. coli. Conclusions: PUBS is considered benign process in the majority of catheterized patients. Clinicians should be aware of the syndrome that may indicate serious comorbidities.

scholarly journals Infeções do Trato Urinário numa Coorte de Transplantados Renais

2014 ◽  
Vol 27 (3) ◽  
pp. 364 ◽  
Author(s):  
Ana Bispo ◽  
Milene Fernandes ◽  
Cristina Toscano ◽  
Teresa Marques ◽  
Domingos Machado ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Hospital Admissions ◽  
Female Gender ◽  
Tract Infections

<strong>Introduction:</strong> Urinary tract infection is the most common infectious complication following renal transplantation and its frequency is insufficiently studied in Portugal. The aim of this study was to characterize the incidence of urinary tract infections and recurrent urinary tract infections in renal transplant recipients.<br /><strong>Material and Methods:</strong> This was a retrospective cohort observational study, obtained from clinical files of all patients who received a renal transplant at the Hospital of Santa Cruz, from January 2004 to December 2005, with a mean follow-up period of five years or until date of graft loss, death or loss of follow-up. After a descriptive analysis of the population, we used bivariate tests to identify risk factors for urinary tract infections.<br /><strong>Results:</strong> A total of 127 patients were included, with a 593 patients.year follow-up. We detected 53 patients (41.7%) presenting with at least one episode of urinary tract infection; 21 patients (16.5%) had recurrent urinary tract infection. Female gender was the only risk factor associated with the occurrence of urinary tract infections (p &lt; 0.001, OR = 7.08, RR = 2.95) and recurrent urinary tract infections (p &lt; 0.001, OR = 4.66, RR = 2.83). Escherichia coli (51.6%), Klebsiella pneumoniae (15.5%) and Enterobacter spp (9.9%) were the<br />most frequently identified pathogens. Patients did not reveal an increased mortality or allograft loss. However, urinary tract infections were the most important cause of hospital admissions.<br /><strong>Discussion:</strong> Female gender was the only risk factor for urinary tract infections in this population. Escherichia coli was the most frequent agent isolated.<br /><strong>Conclusion:</strong> Despite preventive measures, urinary tract infections remain an important cause of morbidity and hospital admissions.<br /><strong>Keywords:</strong> Urinary Tract Infections; Postoperative Complications; Risk Factors; Kidney Transplantation; Portugal.

scholarly journals Prevalence of Bacterial Urinary Tract Infections and Associated Factors among Patients Attending Hospitals in Bushenyi District, Uganda

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Martin Odoki ◽  
Adamu Almustapha Aliero ◽  
Julius Tibyangye ◽  
Josephat Nyabayo Maniga ◽  
Eddie Wampande ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Klebsiella Oxytoca ◽  
Female Gender ◽  
Genitourinary Tract ◽  
Indwelling Catheter ◽  
Cross Sectional ◽  
Factors Associated ◽  
Married Individuals ◽  
Tract Infections

Urinary tract infections (UTIs) are one of the major causes of morbidity and comorbidities in patients with underlying conditions, and it accounts for the majority of the reasons for hospital visit globally. Sound knowledge of factors associated with UTI may allow timely intervention that can easily bring the disease under control. This study was designed to determine the prevalence of UTI by isolating and characterizing the different bacterial etiological agents and to evaluate the factors associated with UTI. In this cross-sectional study, a total of 267, clean catch midstream urine (MSU) samples were collected aseptically and analyzed using standard microbiology methods. Data for the factors associated with UTI were obtained by use of questionnaires and standard laboratory tests for selected underlying conditions. The study revealed 86/267 (32.2%) UTI prevalence among patients attending hospitals in Bushenyi District, Uganda. Escherichia coli was the most prevalent bacterial uropathogen with 36/86 (41.9%) followed by Staphylococcus aureus 27/86 (31.4%), Klebsiella pneumoniae 10/86 (11.6%), Klebsiella oxytoca 6/86 (7.0%), Proteus mirabilis 3/86 (3.5%), Enterococcus faecalis 3/86 (3.5%), and Proteus vulgaris 1/86 (1.2%). This study has demonstrated that age ≤19 years, female gender, married individuals, genitourinary tract abnormalities, diabetes, hospitalization, indwelling catheter <6 days, and indwelling catheter >6 days had statistically significant relationships (p<0.05) with UTI. Screening for UTI in hospitalized patients, female gender, married individuals, genitourinary tract abnormalities, indwelling catheter, and diabetics should be adopted.

scholarly journals Characterization of the urinary microbiota of elderly women and the effects of type 2 diabetes and urinary tract infections on the microbiota

Oncotarget ◽  
2017 ◽  
Vol 8 (59) ◽  
pp. 100678-100690 ◽  
Author(s):  
Fengping Liu ◽  
Zongxin Ling ◽  
Yonghong Xiao ◽  
Qing Yang ◽  
Li Zheng ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Elderly Women ◽  
Urinary Microbiota ◽  
Tract Infections

scholarly journals Vaccination with Proteus Toxic Agglutinin, a Hemolysin-Independent Cytotoxin In Vivo, Protects against Proteus mirabilis Urinary Tract Infection

2008 ◽  
Vol 77 (2) ◽  
pp. 632-641 ◽  
Author(s):  
Praveen Alamuri ◽  
Kathryn A. Eaton ◽  
Stephanie D. Himpsl ◽  
Sara N. Smith ◽  
Harry L. T. Mobley
Keyword(s):  
Urinary Tract ◽  
Proteus Mirabilis ◽  
Parent Strain ◽  
Double Mutant ◽  
Vaccine Development ◽  
Histopathological Examination ◽  
Bacterial Load ◽  
Passenger Domain ◽  
Tract Infections

ABSTRACT Complicated urinary tract infections (UTI) caused by Proteus mirabilis are associated with severe pathology in the bladder and kidney. To investigate the roles of two established cytotoxins, the HpmA hemolysin, a secreted cytotoxin, and proteus toxic agglutinin (Pta), a surface-associated cytotoxin, mutant analysis was used in conjunction with a mouse model of ascending UTI. Inactivation of pta, but not inactivation of hpmA, resulted in significant decreases in the bacterial loads of the mutant in kidneys (P < 0.01) and spleens (P < 0.05) compared to the bacterial loads of the wild type; the 50% infective dose (ID50) of an isogenic pta mutant or hpmA pta double mutant was 100-fold higher (5 × 108 CFU) than the ID50 of parent strain HI4320 (5 × 106 CFU). Colonization by the parent strain caused severe cystitis and interstitial nephritis as determined by histopathological examination. Mice infected with the same bacterial load of the hpmA pta double mutant showed significantly reduced pathology (P < 0.01), suggesting that the additive effect of these two cytotoxins is critical during Proteus infection. Since Pta is surface associated and important for the persistence of P. mirabilis in the host, it was selected as a vaccine candidate. Mice intranasally vaccinated with a site-directed (indicated by an asterisk) (S366A) mutant purified intact toxin (Pta*) or the passenger domain Pta-α*, each independently conjugated with cholera toxin (CT), had significantly lower bacterial counts in their kidneys ( P = 0.001) and spleens (P = 0.002) than mice that received CT alone. The serum immunoglobulin G levels correlated with protection (P = 0.03). This is the first report describing the in vivo cytotoxicity and antigenicity of an autotransporter in P. mirabilis and its use in vaccine development.

scholarly journals The purple urine bag syndrome: a visually striking side effect of a highly alkaline urinary tract infection

2013 ◽  
Vol 5 (4) ◽  
pp. 233 ◽  
Author(s):  
Peter Peters ◽  
Jessica Merlo ◽  
Nicholas Beech ◽  
Chantelle Giles ◽  
Bonita Boon ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Side Effect ◽  
Purple Urine Bag Syndrome ◽  
Purple Urine

scholarly journals Fosfomycin susceptibility among ESBL producing gram negative bacilli causing urinary tract infections

2021 ◽  
Vol 8 (2) ◽  
pp. 142-145
Author(s):  
Rajeshwari K G
Keyword(s):  
Urinary Tract ◽  
Treatment Options ◽  
Study Finding ◽  
Multidrug Resistant ◽  
Oral Antibiotic ◽  
Testing Susceptibility ◽  
Tract Infections ◽  
Common Infection ◽  
Esbl Producers

Urinary tract infection is one of the common infection encountered in day to day practice. Due to emergence of drug resitance among uropathogens treatment options have become limited. Fosfomycin being a safe oral antibiotic is being used widely to treat multidrug resistant uropathogens. In the present study 831 (48.45%) samples that yielded significant growth were processed out of 1715 sample for ESBL detection by double disc synergy and phenotypic confirmatory method. E.coli constituted the predominant isolate (60.4%) followed by K.pneumoniae. 256 (30.80%) samples yielding growth were from out patients and 575 from inpatients. Over all 44% of isolates in the present study were ESBL producers. 50% of Ecoli were ESBL producers. 70.64% of ESBL isolates were susceptible to fosfomycin in vitro. Present study finding suggest that resistance to fosfomysin is on rise even though majority of ESBLs were sensitive to it. The current study recommends to use fosfomycin only after testing susceptibility among uropathogens.

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