紫色尿袋症候群: 5個案例報告及文獻回顧

Purple urine-bag syndrome (PUBS) is a phenomenon in which the contents of urine bags and urinary catheters turn purple or blue following patient catheterization. The condition often causes caregivers tremendous distress. Here we present a case series of such patients: 4 female and 1 male home nursing care patients (mean age=80 years) who were chronically constipated and bed ridden with urinary catheterization, experiencing PUBS for the first time. Urines initially appeared yellowish-brown and had pH values between 7.0 and 8.0. Urine culture yielded multiple bacterial isolates including Pseudomonas aeruginosa, Morganella morganii, Escherichia coli, Klebsiella pneumoniae, etc. These five patients were given additional urinary tract care and bowel care, adequate hydration, and more frequent changes of urinary catheters and bags once PUBS developed. The purple discoloration disappeared after our intervention without antibiotic use.
It is apparent that PUBS is not a disease per se. Rather, it is a phenomenon that may reflect the need for review of the patient's care such as urinary tract and bowel issues and adequate hydration. In general, the best management of PUBS is to focus on eliminating its risk factors. The use of antibiotics is not routinely suggested. With adequate knowledge of PUBS, unnecessary use of antibiotics and laboratory tests can be avoided. Developing good care skills and knowledge is the best prevention strategy for avoiding PUBS.