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Purple urine bags.

S F Dealler1, P W Belfield, M Bedford

  • 1Department of Microbiology, Leeds General Infirmary, United Kingdom.

The Journal of Urology
|September 1, 1989
PubMed
Summary
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Elderly women with chronic urinary catheterization may experience purple urine drainage bags. This phenomenon is linked to bacterial metabolism of indican, resulting in indigo dye formation.

Area of Science:

  • Medical Microbiology
  • Geriatric Medicine
  • Clinical Chemistry

Background:

  • Purple discoloration of urinary drainage bags is an uncommon clinical observation.
  • Previous reports suggest a link between bacterial activity and the purple color.
  • The specific mechanism and causative agents require further elucidation.

Purpose of the Study:

  • To investigate the cause of purple urine drainage bags in chronically catheterized elderly women.
  • To identify the microorganisms involved and the biochemical pathway responsible for the color change.

Main Methods:

  • Observation of purple urine drainage bags in a cohort of elderly women.
  • Analysis of urine for the presence of blue crystals and bacterial cultures.
  • Measurement of indoxyl sulfate (indican) excretion levels.

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Main Results:

  • Purple bags were observed in 7 of 71 chronically catheterized elderly women.
  • The purple staining was attributed to indirubin and indigo, formed from indoxyl sulfate.
  • Urine from affected patients contained bacteria (Providencia or Klebsiella species) that produced blue colonies on agar; indican excretion was higher in these patients.

Conclusions:

  • Bacterial metabolism of indican in urine leads to the formation of indigo and indirubin, causing purple discoloration of catheter bags.
  • Providencia or Klebsiella species are implicated in this process.
  • Elevated indican excretion is associated with the purple urine bag phenomenon.