[Pastel in the urine bag]

Area of Science:

• Urology
• Medical Microbiology

Background:

• Purple urine bag syndrome (PUB S) is a rare condition affecting chronically catheterized patients, predominantly elderly women.
• It involves the discoloration of urine collection bags to purple or blue hues.
• The exact mechanism is not fully understood but involves specific urinary compounds.

Observation:

• This report details two cases of PUB S in a long-term care setting.
• Both patients had indwelling urinary catheters and bacterial colonization.
• Identified bacteria included Escherichia coli and Pseudomonas aeruginosa.

Findings:

• PUB S is associated with the presence of indigo and indirubin compounds in urine.
• These compounds bind to the plastic of urine bags, causing the characteristic purple color.
• Risk factors include constipation, alkaline urine, immobility, institutionalization, and cognitive impairment.

Implications:

• Early recognition of PUB S is crucial for appropriate patient management.
• Understanding the role of bacterial colonization may lead to preventative strategies.
• Further research into the metabolic pathways producing indigo and indirubin is warranted.