Non-transferrin-bound iron is associated with enhanced Staphylococcus aureus growth in hemodialysis patients receiving intravenous iron sucrose.
BACKGROUND
Hemodialysis vascular access infections are most frequently caused by Staphylococcus spp. The purpose of this study was to determine if S. aureus growth is enhanced after administration of IV iron sucrose and to establish a relationship between the appearance of non-transferrin-bound iron (NTBI) and S. aureus growth.


METHODS
Serum samples were obtained from 12 hemodialysis patients receiving maintenance doses of 100 mg of iron sucrose at baseline and 5, 30, 90, 220 min and 48 h after iron administration. Assays for NTBI and transferrin saturation were performed. S. aureus isolates were used to inoculate patient serum samples. Bacterial growth was determined by optical density.


RESULTS
Six of 12 patients had NTBI present within 30 min of the iron dose. NTBI was present more frequently in patients with baseline transferrin saturation values >30% (p < 0.05). Bacterial growth was significantly greater in patients who had NTBI present at 5, 90 and 220 min after iron administration compared to those who did not have NTBI present.


CONCLUSIONS
Doses of 100 mg of iron sucrose are associated with the presence of NTBI and enhanced S. aureus growth.
Barton Pai
Amy
A
University of New Mexico College of Pharmacy, Albuquerque, NM 87131, USA. abpai@salud.unm.edu
Pai
Manjunath P
MP
Depczynski
Joseph
J
McQuade
Charles R
CR
Mercier
Renee-Claude
RC
D005260:Female; D005290:Ferric Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid; D006801:Humans; D007501:Iron / Q000097:blood*; D008875:Middle Aged; D011485:Protein Binding; D006435:Renal Dialysis / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000097:blood* / Q000139:chemically induced* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000254:growth & development*; D014168:Transferrin / Q000032:analysis*
D005290:Ferric Compounds; D014168:Transferrin; D007501:Iron; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid