Effect of iron overload on prevalence of common bacterial infection in thalassemia patients

Abstract

Thalassemia is the most common human monogenic disease in the world, associated with several consequences, including recurrent infections, many studies have demonstrated a high prevalence of infection among individuals with thalassemia accounting for about 10% of cases. This study aimed to detect the effect of serum iron imbalance on the prevalence of infection in thalassemia patients. This research was conducted in the Thalassemia Teaching Department at Al Karama Hospital, between March and October 2023. The case–control study was conducted by comparing 60 people with thalassemia with 60 other people who were not thalassemic but suffering from fever and similar symptoms. Through examining urine, sputum, blood, and skin swab samples, samples with a positive result for the bacteria were identified, their sensitivity to antibiotics was examined, and these results were compared with the control group. Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus, three types of the most common bacteria were chosen for testing due to the limited resources. Control groups of 20 males and 30 females with a mean age of 20 ± 4.5 years compared to 60 nonthalassemia febrile patients classified into 34 males and 26 females with the same age range as control groups. It was discovered that the majority of thalassemia patients are infected with E. coli bacteria. It also depends in its infection rate on an imbalance in the level of iron in the blood, whether it is increased, as in thalassemia, or decreased in cases of iron deficiency anemia that E. coli bacteria is the type that most infects thalassemia patients. Common species of bacteria responsible for infection in thalassemia patients represented by E. coli, K. pneumoniae, and Staphylococcus aureus associated with serum iron level changes highlighting the need for additional research into the impact of iron imbalance on infections. The study found that imipenem and meropenem had a profound effect on the vast majority of bacterial species involved in thalassemia.