Abstract
Background and aims:Thalassemia patients are predisposed to septicemia due to iron overload. The iron chelators have a potential role in the treatment of septicemia. This study was conducted to investigate the in vitro effect of iron chelators, deferoxamine (DFO), deferiprone (DFP), and deferasirox (DFS) on the growth of effective bacteria (Staphylococcus aureus, Yersinia enterocolitica, and Pseudomonas aeruginosa) and their synergistic effect with each other and antibiotics. Materials and Methods: Five bacterial strains were incubated in the presence of seven chelators in Mueller Hinton agar and the number of colonies was recorded for each sample. Antibiotic discs were placed in the plates. Susceptibility to antibiotics was assessed by disc diffusion method (Kirby-Bauer test) and also the zone inhibition around the disc was measured in mm after incubating the relevant plate at 37°C for a day. Results: The growth of all the studied bacteria increased in the presence of iron and was inhibited in the presence of different chelators. Chelators and antibiotics had synergistic effects on growth inhibition of Escherichia coli, S. aureus, and P. aeruginosa in culture medium, while the growth inhibition of Y. enterocolitica was seen in the presence of deferiprone and deferasirox combination. Conclusion: Chelators in combination with antibiotics exert synergistic effects on growth inhibition of prevalent bacteria (except for Y. enterocolitica).
Highlights
Thalassemia is a genetic blood disorder which is characterized by abnormality in the synthesis of hemoglobin beta chain and ranges from severe to asymptomatic anemia [1]
The growth of E. coli, S. aureus, S. epidermidis, Y. enterocolitica, and P. aeruginosa increased in the plate containing Mueller-Hinton agar and antibiotic disc with addition of iron (Table 2)
Increase in the zone of growth inhibition of E. coli was seen in the presence of the antibiotics and chelators, that is, they had a synergistic effect on the growth inhibition of E. coli (Table 2)
Summary
Thalassemia is a genetic blood disorder which is characterized by abnormality in the synthesis of hemoglobin beta chain and ranges from severe to asymptomatic anemia [1]. Major Thalassemia is considered as a severe form of thalassemia which is manifested within the first two years of life and the affected patients should regularly undergo red blood cell transfusion [1]. One of the conditions that could cause death of thalassemia patients is infectious diseases and subsequent septicemia [7,8,9] In these patients, increase in blood ferritin, repeated venous catheterizations, and splenectomy are considered as major risk factors for septicemia. Increase in blood ferritin, repeated venous catheterizations, and splenectomy are considered as major risk factors for septicemia These patients are predisposed to infection with gram-positive and -negative bacteria [10, 11].
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