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. 2018 Jun 28:4:58.
doi: 10.1038/s41394-018-0087-2. eCollection 2018.

Randomized trial of concentrated proanthocyanidins (PAC) for acute reduction of bacteriuria in male veterans with spinal cord injury utilizing clean intermittent catheterization

Samay Sappal  1 , Lance L Goetz  2   3 , Randy Vince  4 , Adam P Klausner  4
Affiliations

Randomized trial of concentrated proanthocyanidins (PAC) for acute reduction of bacteriuria in male veterans with spinal cord injury utilizing clean intermittent catheterization

Samay Sappal et al. Spinal Cord Ser Cases. .

Abstract

Study design: This study was a double-blind, placebo-controlled trial of a concentrated PACs compound (36 mg/capsule), in veterans with SCI and neurogenic lower urinary tract dysfunction (NLUTD) requiring intermittent catheterization (IC) over a 15-day period.

Objectives: The objective of this study was to evaluate the acute effects of concentrated proanthocyanidins (PACs) in the cranberry supplement ellura® on bacteriuria, leukocyturia, and subjective urine quality in catheter-dependent veterans with SCI.

Setting: Spinal cord injury center (outpatient clinic and inpatient unit).

Methods: Participants with positive urine bacterial colonization (≥50 K CFU/ml) were randomized to once daily concentrated PACs or identical placebo and followed with daily (in-patients) or twice weekly (out-patients) urine cultures with colony forming units per milliliter (cfu/ml) range (bacteriuria), microscopic urine white blood cells per high-powered field (wbc/hpf) quantification (leukocyturia), and surveys assessing urine clarity, odor, color, sediment, and overall satisfaction. A repeated measure analysis of variance was used to compare treatment vs. control and evaluate serial trends.

Results: A total of 13 male participants (7 randomized to concentrated PACs, 6 to placebo) completed the trial. There was no significant decrease over the study period in colony forming units per milliliter (cfu/ml) or log(wbc/hpf) in the treatment vs. the control group. Patients receiving concentrated PACs rated the clarity, odor, color, sediment, and overall satisfaction of their urine as insignificantly improved compared to placebo.

Conclusions: Acutely, there was no reduction of bacteriuria and pyuria or improvement in subjective urine quality for SCI patients treated with daily concentrated PACs.

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Conflict of interest statement

Compliance with ethical standardsThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Mean bacterial colony count. Scatter plot with positive and negative error bars representing mean bacterial colony count for all patients over the 15-day trial period. Key indicates conversion of incremental lab reported values to discrete values for the purposes of statistical analysis
Fig. 2
Fig. 2
Logarithmic form of the mean urinary white blood cell count. Scatter plot with positive and negative error bars representing the mean urinary white blood cell count for all patients over the 15-day trial period. The logarithmic form of the data were used for statistical analysis because of the variability of the data
Fig. 3
Fig. 3
Overall satisfaction with urine quality. Scatter plot with positive and negative error bars representing the mean rating of overall satisfaction with urine quality for all patients over the 15-day trial period. Rating scale of 1–5 was used, with 1 indicating much worse and 5 indicating much improved from baseline
See this image and copyright information in PMC

References

    1. Siroky MB. Pathogenesis of bacteriuria and infection in the spinal cord injured patient. Am J Med. 2002;113:67S–79S. doi: 10.1016/S0002-9343(02)01061-6. - DOI - PubMed
    1. Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE, Rice JC, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010;50:625–63. doi: 10.1086/650482. - DOI - PubMed
    1. Goetz LL, Cardenas DD, Kennelly M, Bonne Lee BS, Linsenmeyer T, Moser C, et al. International spinal cord injury urinary tract infection basic data set. Spinal Cord. 2013;51:700–4. doi: 10.1038/sc.2013.72. - DOI - PubMed
    1. Linsenmeyer TA, Oakley A. Accuracy of individuals with spinal cord injury at predicting urinary tract infections based on their symptoms. J Spinal Cord Med. 2003;26:352–7. doi: 10.1080/10790268.2003.11753705. - DOI - PubMed
    1. Massa LM, Hoffman JM, Cardenas DD. Validity, accuracy, and predictive value of urinary tract infection signs and symptoms in individuals with spinal cord injury on intermittent catheterization. J Spinal Cord Med. 2009;32:568–73. doi: 10.1080/10790268.2009.11754562. - DOI - PMC - PubMed

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