Association of iron status with the risk of bloodstream infections: results from the prospective population-based HUNT Study in Norway

Abstract

Indices of severe iron deficiency are associated with an increased risk of a future BSI.

Iron deficiency and infection: another pathway to explore in critically ill patients?

“…These links between low iron concentration and greater inflammation may explain the results observed by Mohus et al [8] published in the Journal. In a cohort population of 61,852 individuals with a 15-year follow-up, these authors observed an increased risk of bloodstream infections in patients with low iron status.…”

“…The value of haemoglobin could give additional information on the severity of iron deficiency. In this study [8], it is not possible to know if iron deficiency alone is the problem or if it was both that were predictive of bloodstream infections.…”

“…We do not know whether the patients were supplemented with iron or if the iron status evolved. To answer this question, the authors looked at the iron prescriptions in the general population during the study period and reported that the daily intake of iron was lower than the recommendations, suggesting probably a persistence of iron deficiency in the population studied [8]. This indirect evidence is supported by another report showing that iron deficiency is often underestimated in the general population [9].…”

“…Finally, aetiologies of anaemia observed in critically ill patients are multifactorial and different from the general population included in the study of Mohus et al [8]. This includes blood loss (surgery, gastrointestinal bleeding and blood sampling) but also decreased erythrocyte production (real or functional iron deficiency due to inflammation, decreased synthesis in erythropoietin) and a decrease of red blood cells lifespan [1,10].…”

Focus on infection

“…Using a large stepped-wedge cluster randomized-controlled multicenter intervention design, it was able to demonstrate that basic measures such as central venous catheter insertion strategy and a hand hygiene improvement strategy decreased CRBSI rates [15]. And finally, a large study with over 60,000 patients who were followed for a median of 14.8 years with indices of iron deficiency identified those with low serum iron and transferrin saturation (Tsat) and high total iron-binding capacity (TIBC), as being at a higher bloodstream infections risk [16].…”