Biochemical and bacteriological investigation of six cases of purple urine bag syndrome (PUBS) in a geriatric ward for dementia

Muneoka, Katsumasa; Igawa, Mariko; Kurihara, Noriko; Kida, Jiro; Mikami, Takuma; Ishihara, Isamu; Uchida, Junko; Shioya, Kiriko; Uchida, Shunya; Hirasawa, Hideto

doi:10.3143/geriatrics.45.511

Cited by 11 publications

(7 citation statements)

References 18 publications

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“…Although an alkaline urine is an important factor for the phenomenon of PUBS as observed in most of the studies,[341617] some studies have reported PUBS even in acidic urine pH. [1819]…”

Section: Discussionmentioning

confidence: 99%

Purple urine bag syndrome: A case report and review of literature

Yaqub¹,

Mohkum²,

Mukhtar³

2013

Indian J Nephrol

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Purple urine bag syndrome (PUBS) is an infrequent condition, seen mostly in elderly female patients, characterized by an intense purple discoloration of contents of urine bag following long-term indwelling urinary catheterization. The purple discoloration is most often due to the presence of indigo and indirubin pigments which are metabolites of tryptophan. Urinary bacteria with indoxyl sulphatase activity metabolize indoxyl sulphate to produce indigo and indirubin, particularly in alkaline urine. We report an elderly woman with a urinary tract infection and constipation who presented with PUBS. The purple urine disappeared after antibiotic therapy and change of the urine bag. To the best of our knowledge, this is the first case of PUBS reported from this region.

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“…Although an alkaline urine is an important factor for the phenomenon of PUBS as observed in most of the studies,[341617] some studies have reported PUBS even in acidic urine pH. [1819]…”

Section: Discussionmentioning

confidence: 99%

Purple urine bag syndrome: A case report and review of literature

Yaqub¹,

Mohkum²,

Mukhtar³

2013

Indian J Nephrol

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“…Biochemical and bacteriological investigation of six cases of PUBS was conducted in a geriatric ward for dementia [ 18 ]. Muneoka et al investigated 6 cases exhibiting PUBS (3 males and 3 females).…”

Section: Gut Microbiota Covid-19 Dementia and Biogenic Aminesmentioning

confidence: 99%

Induction of Gut Microbial Tryptamine by SARS-CoV-2 in Nonhuman Primate Model Consistent with Tryptamine-Induced Model of Neurodegeneration

Paley

2021

ADR

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The author discussed recently the possible molecular mechanisms that cause the COVID-19 disease symptoms. Here the analysis of the recent experimental data supports the hypothesis that production of the gut microbial tryptamine can be induced by the SARS-CoV-2 fecal viral activity due to the selective pressure or positive selection of tryptamine-producing microorganisms. In this report, the author suggests that the mechanism of microbial selection bases on the abilities of tryptamine to affect the viral nucleic acid. In other words, the gut microorganisms producing tryptamine are more resistant to SARS-CoV-2 fecal viral activity than microorganisms producing no tryptamine. Earlier we demonstrated the induction of neurodegeneration by tryptamine in human cells and mouse brain. Furthermore, we were able to uncover the human gut bacteria associated with Alzheimer’s disease (AD) using PCR testing of human fecal samples with the new-designed primers targeting the tryptophan-tryptamine pathway. Likely, SARS-CoV-2 is one of the selective pressure factors in the cascade accelerating the neurodegenerative process in AD. This suggestion is consistent with a higher proportion of AD patients among COVID-19 related victims. Gut microbial tryptamine increase due to the viral infection-induced dysbiosis can synergize and potentiate the tryptamine cytotoxicity, necrotizing ability and other properties as a virulence factor.

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“…Although the alkaline state of the urine is thought to be responsible for the formation of indigo and indirubin, with a purple-colored appearance, some cases of PUBS without alkaline urine have also been reported 5,12. Hence, alkaline urine may be one of the facilitating factors for diagnosis of PUBS.…”

Section: Laboratory Findingsmentioning

confidence: 99%

“…The common bacterial strains cultured from the urine bag are shown in Table 1 2,7,13. The purple pigment in the urine is thought to originate from indican and indirubin (Figure 2), but there are some reports of cases of PUBS without any evidence of indicanuria 2,5. The pathogenesis of purple PUBS is due to metabolism of tryptophan by intestinal bacteria such as Proteus mirabilis to indole and conversion to indoxyl sulfate in the liver.…”

Section: Laboratory Findingsmentioning

confidence: 99%

An update on purple urine bag syndrome

Hadano¹,

Shimizu²,

Takada³

et al. 2012

IJGM

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Purple urine bag syndrome is characterized by the urinary drainage bag turning purple in patients on prolonged urinary catheterization, especially those in the bedridden state. It is associated with bacterial urinary tract infections caused by indigo-producing and indirubin-producing bacteria, usually affects women, and is associated with alkaline urine, constipation, and a high bacterial load in the urine. Almost all patients with purple urine bag syndrome are catheterized due to significant disability, and the urinary pH is 7.0 or more. In general, intensive treatment with antibiotics is not recommended. Purple urine bag syndrome per se almost always appears to be asymptomatic and harmless. However, caution is needed, because some cases have been reported to show progression to severe disease states, so further research into the morbidity and mortality of this infection is warranted.

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Biochemical and bacteriological investigation of six cases of purple urine bag syndrome (PUBS) in a geriatric ward for dementia

Cited by 11 publications

References 18 publications

Purple urine bag syndrome: A case report and review of literature

Purple urine bag syndrome: A case report and review of literature

Induction of Gut Microbial Tryptamine by SARS-CoV-2 in Nonhuman Primate Model Consistent with Tryptamine-Induced Model of Neurodegeneration

An update on purple urine bag syndrome

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