IV Iron, a Contributor to Common Infections? - IVICCI
Research type
Research Study
Full title
Does the current practice of intravenous iron treatment raise the risk of peri-operative infection by common bacterial pathogens?
IRAS ID
281856
Contact name
Doug Barker
Contact email
Sponsor organisation
Royal Berkshire NHS Foundation Trust
Duration of Study in the UK
1 years, 6 months, 1 days
Research summary
Intravenous (IV) iron is used to treat iron-deficiency anaemia prior to major surgery. This results in raised red blood cell levels which reduces the need for post-surgical blood transfusion. Although such advantages are seen in heart surgery, it is unclear how efficacious IV iron treatment is for patients in whom transfusion rates are much lower, especially when the IV iron treatment is delivered close to the point of surgery (e.g. in cancer patients) giving little opportunity for any benefit to materialise.
Pathogenic bacteria require iron and utilise specific virulence mechanisms to wrest iron from their host. Further, catecholamine stress hormones act as iron-mobilisation agents mediating delivery of iron to bacteria increasing infection potential. Thus, IV iron therapy may promote infection. It is unclear how long and at what levels IV iron persists in the blood, and to what degree it supports pathogens or is mobilised by catecholamines. Thus, the infection risk posed by IV iron applied shortly before surgery remains unknown.
To address this knowledge gap and enable improvements in IV iron treatment, we will test whether IV iron formulae support growth and virulence (with and without noradrenaline) of relevant bacterial pathogens in blood from patients and controls. This is a small scale pilot study to guide future study design.
REC name
HSC REC B
REC reference
23/NI/0017
Date of REC Opinion
24 Jan 2023
REC opinion
Favourable Opinion