Department of Internal Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Department of Internal Medicine, Razi Clinical Research Development Unit, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.
BMC Nephrol. 2024 Oct 24;25(1):375. doi: 10.1186/s12882-024-03708-6.
Purple urine bag syndrome (PUBS) is a rare and unusual event. It is related to symptomatic urinary infection and asymptomatic bacteriuria in patients with indwelling bladder catheters. The purple color of the urine is due to metabolic products of biochemical reactions formed by bacterial enzymes in the urine. Gastrointestinal tract flora breaks down the amino acid tryptophan into indole, which is subsequently absorbed into the portal circulation and converted into indoxyl sulfate. Indoxyl sulfate is then excreted into the urine, where it can be broken down into indoxyl if the appropriate alkaline environment and bacterial enzymes are present. The breakdown products, indigo, and indirubin appear blue and red. We reported on an elderly woman who was kept in a nursing home, had multiple comorbidities such as history of cerebrovascular accident (CVA), acute kidney injury (AKI) and she was hospitalized due to decreased consciousness, fever and kidney failure. On the third day of hospitalization, the patient developed PUBS while undergoing urinary catheterization in the hospital. She had no history of previous catheterization and chronic use of antibiotics, she was only using Tolterodine for a long time due to urinary urgency. Due to antibiotic resistance, the drugs were not changed and the purple color disappeared after changing the catheter and urinary bag.This was the first patient in this region to be reported with this manifestation.
紫色尿袋综合征（PUBS）较为罕见且不常见。它与留置导尿管患者的有症状尿路感染和无症状菌尿有关。尿液呈紫色是由于尿液中的细菌酶代谢产物形成的生化反应。胃肠道菌群将氨基酸色氨酸分解为吲哚，吲哚随后被吸收到门静脉循环并转化为吲哚硫酸酯。吲哚硫酸酯随后被排泄到尿液中，如果存在合适的碱性环境和细菌酶，它可以分解为吲哚。分解产物靛蓝和靛玉红呈蓝色和红色。我们报告了一位住在养老院的老年女性，她患有多种合并症，如脑中风（CVA）病史、急性肾损伤（AKI），因意识下降、发热和肾衰竭住院。住院第三天，在医院进行导尿时，患者出现紫色尿袋综合征。她没有先前的导尿史和慢性使用抗生素的病史，只是由于尿急长期使用托特罗定。由于抗生素耐药，未更换药物，更换导尿管和尿袋后紫色消失。这是该地区首例有此表现的患者。
