title: Purple urine bag syndrome: a community-based study and literature review.
abstract: OBJECTIVE
  Purple urine bag syndrome (PUBS) is considered as an uncommon phenomenon. This cohort study aimed to figure out the causative factors and the potential risks of PUBS.
  
  
  METHODS
  We recruited 84 patients with long-term urinary catheterization from seven nursing institutions and home care centre, then compared the differences of demographic, clinical, urine test and bacteriological data between the patients with and without PUBS.
  
  
  RESULTS
  The 2-month period prevalence of PUBS in chronic catheterized patients was 16.7%. PUBS-affecting patients had significantly higher proportion of female gender (P = 0.034), self oral intake (P = 0.036) and eating self-prepared food (P = 0.007). Otherwise, no statistical associations were found. Five different bacterial species were isolated from the urine of PUBS-affecting patients. No sequelae were found after forward follow-up for 6 months. We further discuss the associations between certain factors and PUBS according to literature review and the results of our study.
  
  
  CONCLUSIONS
  PUBS is not as rare as we thought before. The causative factors of PUBS have not been clearly characterized. It may be the combination of several factors that cause the PUBS. Female gender and food content were found to be associated factors of PUBS in our study. Asymptomatic PUBS is unnecessary to be treated by antibiotics.
authors.affiliation: Department of Nephrology, Lotung St Mary's Hospital, I-Lan, Taiwan.
authors.forename: Chih-Chung
authors.initials: CC
authors.lastname: Shiao
authors.forename: Ching-Yi
authors.initials: CY
authors.lastname: Weng
authors.forename: Jui-Chu
authors.initials: JC
authors.lastname: Chuang
authors.forename: Mao-Sheng
authors.initials: MS
authors.lastname: Huang
authors.forename: Zen-Yong
authors.initials: ZY
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003116:Color; D003248:Constipation / Q000652:urine; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007203:Indigo Carmine; D007211:Indoles / Q000378:metabolism / Q000652:urine*; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D014546:Urinary Catheterization / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000652:urine
chemical_list: D007211:Indoles; C030374:indole; D007203:Indigo Carmine; C027185:indirubin