紫色尿袋症候群 4年內7位老年住院病例之觀察

1 2010 21 155-161 408 36 4 7 1,3 2 4 1 2 3 4 (purple urine bag syndrome) 1978 2006 Komiyama (purple diaper syndrome) 1 (tryptophan) (indole) (indoxyl sulphate) (phosphatase) (sulfatase) (indirubin) (indigo) 4 12 11 ( ) 1 ( )

2 5 7 3 4 2 2 3 3 C pH C pH 7 C pH 9 (Purple urine bag syndrome) (Tryptophan) (Symptomatic urinary tract infection) 156 2 3 95% 4.

3 5 2004 7 2008 9 4 491 299 70% 45 (Aution MaxTM, Arkray) Nicolle 6,7 ( ) 103 CFU/ml 10 ( ) C C ( ) ( ) ( ) 12 11 ( ) 1 ( )

4 12 1 X 5 7 80 2008 8 18 4 83 2007 9 28 cephazolin gentamycin 8 83 2006 6 18 cephazolin gentamycin 6 78 2005 6 27 157 5 87 2005 1 22 5 91 2004 10 19 C ICD 5 92 2004 7 12 10 7 7

5 Escherichia coli Proteus mirabilis Klebsiella pneumoniae Escherichia fergusonii (Escherichia coli) (Proteus mirabilis) pH C 13625 /mm3 pH 20-30 /HPF 7 C 9900 /mm3 pH 25-30 /HPF 9 C 6203 /mm3 pH 12-20 /HPF

6 8,9 8( 158 * 80 83 83 ( C) (/mm3) 4060 17560 9690 (%) (pH) (/HPF) 10-20 10-20 30-40 Escherichia coli Escherichia coli. Klebsiella Proteus mirabilis pneumoniae(CFU/ml) 105 105 105 Cephazolin Cephazolin Gentamycin Gentamycin magnesium oxide magnesium oxide sennoside sennoside 97/8/18 96/9/28 95/6/18 97/8/21 96/10/5 95/6/23 4 8 6 PVC PVC PVC 78 87 91 92 ICD ICD 9570 4980 11860 7940 7-10 20-30 40-50 10-20 Proteus mirabilis Proteus mirabilis Escherichia Escherichia coli fergusonii Proteus mirabilis 105 105 105 105)

7 Sennoside sennoside magnesium oxide sennoside 94/6/27 94/1/22 93/10/19 93/7/12 94/7/1 94/1/26 93/10/26 93/7/21 5 5 8 10 PVC PVC PVC PVC*-ICD:international classification of diseases; PVC: polyvinylchloride. ( C) (/mm3) (%) (pH) (/HPF) (CFU/ml) 159 ) 3,8 5 (hemolysin) (fimbriae)

8 NH3 10 2,8 2160 2 Bisacodyl 8 3,6 24 8 1 NH3 2 3 (NaHCO3) (citrate) 4 (renal tubular acidosis) 11 1 2 3 thiazide (Mandelic Acid) 4 11 (pH )

9 12 2008 230 2016 15% 1.

10 Komiyama A. Purple diaper syndrome in geriatrics. J Am Geriatr Soc 2006; 54: 1954-5. 2. Harun NS, Nainar SKMSH, Chong VH. Purple urine bag syndrome a rare and interesting phenomenon. South Med J 2007; 100: 1048-50. 3. Chung YC, Hwang HL. Long-term catheter-associated urinary tract infection: nursing care of the purple urine bag syndrome. J Long-Term Care 2006; 10: 426-35. 4. Lin HH, Li SJ, Su KB, Wu LS. Purple urine bag syndrome a case report and review of the literature. J Intern Med Taiwan 2002; 13: 209-12. 5. Chiang HC, Su FH, Huang MS, Liu YL, Lin TH, Chu FY. Purple urine bag syndrome: a report of 5 cases and review of the literature.