Effectiveness of Cranberry Ingestion on Bacterial Adhesion: An Adjunct Study

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00506025
Recruitment Status : Completed
First Posted : July 25, 2007
Results First Posted : June 8, 2010
Last Update Posted : December 18, 2017
Information provided by (Responsible Party):
Deborah A. Wing, University of California, Irvine

Brief Summary:
This study is to help determine if drinking cranberry juice can decrease risk for asymptomatic bacteriuria (ASB). ASB occurs when there are bacteria in the urine without any symptoms. It will also see if there is a difference in this effect between pregnant and non-pregnant women.This research project is also designed to see what happens to bacterial binding to the lining of the bladder after drinking cranberry juice when special problems occur with pregnancy such as diabetes (a sugar metabolism problem) or ASB is already occurring.

Condition or disease Intervention/treatment Phase
Asymptomatic Bacteriuria Dietary Supplement: Cranberry Juice Dietary Supplement: De-Activated Cranberry juice Not Applicable

Detailed Description:

This study is an adjunct to a proposal the premise of which is daily cranberry ingestion during pregnancy may be an effective preventative approach to development of asymptomatic bacteriuria (ASB), a condition which predisposes to both preterm birth and upper urinary tract infection. We proposed to NCCAM a pilot randomized, controlled trial (RCT) in which pregnant women beyond 12 weeks' gestational age will be assigned to one of three schedules for cranberry ingestion: Group A will consume cranberry juice twice a day with breakfast and dinner; Group B will consume cranberry juice at breakfast followed by placebo at dinner; and Group C will consume placebo with meals. Both the cranberry juice and placebo will be of scientific grade, provided by an NIH-contractor. Both are well-characterized, presenting a low-carbohydrate load and low-calorie content per dose (40 cal per 8 oz. dose). Our intent is to 1) generate data comparing the frequency of asymptomatic bacteriuria in pregnant women consuming cranberry juice daily versus placebo, and to 2) create the infrastructure to complete this pilot study and to gather sufficient data to support an R01 for a larger, multi-center RCT focused on the prevention of ASB in pregnancy with daily cranberry juice ingestion.

The reviewers of our proposal enumerated specific weaknesses including 1) a need to evaluate urine from cranberry treated patients, and 2) consideration of bacterial virulence/adherence. The additional variable of gestational diabetes also received comment from the reviewers, and we acknowledge that predisposition in the Hispanic population to this obstetrical complication could impact results. A constituent of cranberries is fructose, which has been implicated in the inhibition of E. coli with type 1 fimbriae (mannose-sensitive) (2). We hypothesize that the glucosuria associated with diabetes in pregnancy may influence the effectiveness of cranberry to prevent asymptomatic bacteriuria.

We must address these weaknesses to strengthen chances for continued funding and competitive renewal.

We have made inquiries with other researchers, and have discovered no direct urine or serum assays by which to measure cranberry metabolites. We understand that there is an R21 proposal under consideration to develop a urinary assay for this purpose under the same RFA. Amy Howell, PhD, of the Marucci Center for Blueberry/Cranberry Research of Rutgers University, one of the field's foremost researchers in this field, and others have indirectly assayed compliance to cranberry by evaluating adherence of piliated E. coli strains before and after cranberry exposure (1). In response to the recent call for proposals for faculty research from the UCI Committee on Research, I proposed this pilot study in collaboration with Dr. Howell.

In this proposal, we will collect the urine from various participants in the R21 trial so as to characterize the effect of cranberry juice ingestion on bacterial adherence. We will ask women to collect their urine for a four-hour time period including first-morning void. The urine samples will be sent to Dr. Howell's laboratory at Rutgers University for analysis. We will collect urine from pregnant women who are assigned to cranberry and to placebo, and from those women who develop bacteriuria following cranberry and following placebo ingestion. We also plan to identify a group of reproductive age, healthy, and non-pregnant women to ingest the active cranberry product or placebo for three days, and on the third day, collect a four-hour timed sample in the same manner as the pregnant women in our control group.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 51 participants
Allocation: Non-Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)
Primary Purpose: Other
Official Title: Effectiveness of Cranberry Ingestion on Bacterial Adhesion: Adjunct to Pilot Study of Daily Cranberry Ingestion of Cranberry Juice for the Prevention of Asymptomatic Bacteriuria in Pregnancy
Study Start Date : August 2006
Actual Primary Completion Date : February 2008
Actual Study Completion Date : February 2008

Arm Intervention/treatment
Active Comparator: Cranberry 2xday
Cranberry juice (C) two times daily, a.m. and p.m.
Dietary Supplement: Cranberry Juice
Low-calorie, Low-carbohydrate content 8 oz dose of Cranberry juice

Active Comparator: Cranberry + Placebo
De-Activated Cranberry juice in the am, then placebo (P) in the pm
Dietary Supplement: Cranberry Juice
Low-calorie, Low-carbohydrate content 8 oz dose of Cranberry juice

Placebo Comparator: Placebo 2xday
Placebo in the form of juice two times daily in the a.m. and p.m.
Dietary Supplement: De-Activated Cranberry juice
De-Activated Cranberry juice in the am, then placebo (P) in the pm

Primary Outcome Measures :
  1. Antimicrobial Activity of Urine From Pregnant Subjects Following Cranberry Juice Cocktail (CJC) [ Time Frame: 7 months, from enrollment at 3 months of pregnancy to delivery ]
    The primary outcome measure was the measurement of bacteriuria in study subject urine, defined as having a urine culture with 100,000 or more of a single uropathogen (measured as cfu per ml).

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Ages Eligible for Study:   18 Years to 45 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Intrauterine pregnancy
  • Documented fetal viability (either by fetal heart tones present by Doppler auscultation, or by ultrasonic visualization of cardiac motion
  • Estimated gestational age by last menstrual period and/or by ultrasonographic fetal measurements of 16 weeks or less

Exclusion Criteria:

  • Exclusion criteria will include:
  • Suspected non-viable or ectopic gestation
  • Patient desires pregnancy termination
  • Significant underlying medical complication, such as chronic hypertension, insulin-requiring diabetes, chronic renal failure, cardiac disease, sickle cell disease, etc.
  • Maternal age less than 18 years
  • Patient is currently on or has received within the two weeks prior to enrollment antimicrobial therapy for reasons other than urinary tract infection.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00506025

United States, California
University of California, Irvine Medical Center
Orange, California, United States, 92868
Sponsors and Collaborators
University of California, Irvine
Principal Investigator: Deborah A Wing, MD University of California, Irvine

Responsible Party: Deborah A. Wing, Director, Division of Maternal-Fetal Medicine, Obstetrics & Gynecology, University of California, Irvine School of Medicine, University of California, Irvine Identifier: NCT00506025     History of Changes
Other Study ID Numbers: 2006-4896
First Posted: July 25, 2007    Key Record Dates
Results First Posted: June 8, 2010
Last Update Posted: December 18, 2017
Last Verified: November 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Keywords provided by Deborah A. Wing, University of California, Irvine:
Asymptomatic Bacteruria

Additional relevant MeSH terms:
Urinary Tract Infections
Urologic Diseases