The use of cranberry juice cocktail as an anti-adherence agent for the control of chronic urinary tract infection in catheterized patients

Abstract

In vitro and in vivo assays have demonstrated that cranberry juice and cranberry juice cocktail, a derivative beverage, are powerful inhibitors of bacterial adherence to uroepithelia cells, indicating the possible use of the juice for the treatment or prevention of urinary tract infection. This study looks at the capacity of cranberry juice cocktail (CJC) to induce anti-adherence activity in the urine of a compromised population. Factors which increase the risk of infection of the urinary tract include sex, in which females are at higher risk, old age, residence in extended care facilities, indwelling urethral catheterization, and decreased functional capacity. Eight elderly female subjects, all catheterized and nursing home residents at various levels of decreased functional capacity were given 4 ounces of CJC daily for a period of twelve weeks. Urine specimens were collected on three days in the week prior to the first ingestion of CJC and then 24 hours, 48 hours, and 72 hours after the beginning of cranberry juice administration, and then weekly for the next twelve weeks of daily CJC consumption. The urine specimens were used as the reaction medium for adherence assays of bacteria isolated from the individual patients to healthy donor uroepithelia cells. Mean bacterial adherence in the presence of the base-line control urine was compared to the mean bacterial adherence in the presence of urine collected throughout the remainder of the study. Significantly more anti-adherent urine after CJC consumption was demonstrated in four of the eight patients in comparison to the base-line controls.Average reductions of bacterial adherence of 62%, 46%, 42%, and 28% were observed in the presence of urine collected during the twelve weeks of CJC ingestion for these four patients. Two more of the subjects exhibited average increases in the anti-adherence activity of their urine during the period of CJC ingestion, but not to significant levels. A common patter was observed in the induction of significant anti-adherence activity for three of the four patients with significantly anti-adherent urine in which the activity was not obvious until four weeks after the initiation of CJC consumption. The effect observed beginning on the fourth week was very strong and remained at the same approximate level for the remainder of the study. The results of this study provide evidence that cranberry juice or derivatives of the juice could be very useful for the reduction of UTI in this high risk population.