Intestinal colonization withClostridium difficile in infants up to 18 months of age

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The faecal colonization withClostridium difficile was investigated among 343 infants during their first 18 months of life. Rectal swabs were taken at the ages of 6 days, 6 weeks, 6 months, 11 months and 18 months. About 25 % of the children were colonized withClostridium difficile between 6 days and 6 months of age. The colonization rate decreased to 3 % at 18 months of age. The rate of strains producing cytotoxin was low in infants less than 6 months of age, but at that age about half of the strains isolated were toxin-producing. Breast-fed children were significantly less often colonized withClostridium difficile than were bottle-fed infants, both at 6 weeks of age (21 % versus 47 %, p<0.05) and at 6 months of age (19 % versus 39 %, p<0.001). Colonization withClostridium difficile at 6 months of age was associated with a greater frequency of diarrhoeal disease between 6 and 11 months of age (27 % versus 16 %, p<0.05). This association was even more pronounced when the bacteria persisted at 11 months of age (54 %, p<0.01). Antibiotic therapy could not be demonstrated to influence colonization withClostridium difficile at any age.