Purple urine bag syndrome and dementia. Could E. Coli PUBS be a risk factor for development of sporadic Alzheimer disease? A review of literature

P. Canepa

“Santa Corona” Hospital, Pietra Ligure (SV), Italy

Introduction. PUBS (purple urinary bag syndrome) is determined by tryptophan, which is metabolized by intestinal bacteria (like E. Coli) and expelled into the urine. This syndrome is common in bedridden patients, usually with urinary cathetherization and neurological comorbidities like dementia. Latest evidences show a possible role of E. Coli in Alzheimer disease.

Materials and methods. The PubMed database was evaluated according to year of pubblication (2000-2018) and following search keys: “Purple urine bag syndrome”, “Gram-PUBS”, “Dementia Purple urine bag syndrome”, “E. Coli PUBS”, “E. Coli Alzheimer disease”, “Gram-Alzheimer disease”. Search criteria were focused on citations describing prognosis and correlation of PUBS with neurological comorbidities and correlation between Gram – and neurophysiopathology of AD

Results. 8 references (3 case reports, 2 case series, 1 cohort study, 2 RCT) were found out of 344 citations evaluated.

Conclusions. Latest evidences show a direct link between Gram- and B-amyloid genesis. Further studies are required to clearly define if E. Coli PUBS might be a risk factor for development of sporadic Alzheimer disease.

Download PDF