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Aims: The study focused on finding if there is any possible relation between the intestinal bacterial population quantitative and qualitative and the deficiency of the most important iron compounds as haem precursors. Methodology and Results: Blood complete picture and stool analyses were done to 750 volunteer cases whom were asked for these analyses by their physicians. Analyses proved that 560 cases representing 75.2 % were anemic as the RBC(s) based on counts of the total studied cases of less than 263 x 10 4 and the haemoglobin amount ranged between 7.2 and 11.3 g/dl, while the remainder 24.8 % of the volunteer sample was not anemic. A high male/female ratio of anemic cases, 1:27 was also documented. Considering that all the studied stool samples should be completely free from any parasites or any other anemia-related diseases was a priority. Bacteriological analysis of stool samples of the anemic cases resulted in the detection of high counts of total viable bacteria, exceeded 42 x 10 9 cfu/g, while it was never more than 26 x 10 6 cfu/g and decreased to 4 x 10 6 cfu/g in many cases in this study. Identifying of the 361 bacterial isolates, were found to belong to 12 genera and 19 species, 6 of them; Pseudomonas putrefaciens, Micrococcus luteus, Erysipelothrix rhusiopathiae, Bacillus megaterium, Bacillus pumilus and Bacillus coagulans , were found and in high counts in the stool samples of only anemic cases. The ability of these isolates to compete for iron compounds such as ferrous fumarate alone or with glucose and phytate as activators or inhibitors to these abilities was investigated. Results proved 11 species out of the 19 identified species are capable to use and compete on ferrous fumarate as a haem precursor. Sensitivity test for the representatives of the 19 species and 6 of the most commonly used antibiotics in the Egyptian pharmacy, using standard disc method, revealed variable susceptibilities of almost all of them to more than one of the studied antibiotics, except Corynebacterium equatium, which was found very resistant to two antibiotics; colistin sulfate and erythrocin. Conclusion, significance and impact of study: The study finally concluded the strong role of intestinal bacterial counts and types as competitors on the haem precursor iron-containing compounds like ferrous fumarate.

Intestinal Bacterial Flora that Compete on the Haem Precursor Iron Fumarate in Iron Deficiency Anemia Cases