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

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Abstract

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.

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References

  1. Aronsson, B., Möllby, R., Nord, C.-E. Antimicrobial agents andClostridium difficile in acute enteric disease: epidemiological data from Sweden. Journal of Infectious Diseases 1985, 151: 476–481.

    PubMed  Google Scholar 

  2. Viscidi, R. P., Bartlett, J. G. Antibiotic-associated pseudomembraneous colitis in children. Pediatrics 1981, 67: 381–386.

    PubMed  Google Scholar 

  3. Sutphen, J. L., Grand, R. J., Flores, A., Chang, T. W., Bartlett, J. G. Chronic diarrhoea associated withClostridium difficile in children. American Journal of Diseases in Childhood 1983, 137: 275–278.

    Google Scholar 

  4. Ellis, M. E., Mandal, B. K., Dunbar, E. M., Bundell, K. R. Clostridium difficile and its cytotoxin in infants admitted to hospital with infectious gastroenteritis. British Medical Journal 1984, 288: 524–526.

    PubMed  Google Scholar 

  5. Price, E. H., Wright, V. M., Walker-Smith, J. A., Tabaqchali, S. Clostridium difficile and acute enterocolitis. Archives of Diseases in Childhood 1988, 63: 543–545.

    Google Scholar 

  6. Viscidi, R., Willey, S., Bartlett, J. G. Isolation rates and toxigenic potential ofClostridium difficile isolates from various patient populations. Gastroenterology 1981, 81: 5–9.

    PubMed  Google Scholar 

  7. Holst, E., Helin, I., Mårdh, P.-A. Recovery ofClostridium difficile from children. Scandinavian Journal of Infectious Diseases 1981, 13: 41–45.

    PubMed  Google Scholar 

  8. Larson, H. E., Barclay, F. E., Honour, P., Hill, I. D. Epidemiology ofClostridium difficile in infants. Journal of Infectious Diseases 1982, 146: 727–733.

    PubMed  Google Scholar 

  9. Cooperstock, M., Riegle, L., Woodruff, C. W., Onderdonk, A. Influence of age, sex, and diet on asymptomatic colonization of infants withClostridium difficile. Journal of Clinical Microbiology 1983, 17: 830–833.

    PubMed  Google Scholar 

  10. Gästrin, B., Kallings, L. O., Marcetic, A. The survival time for different bacteria in various transport media. Acta Pathologica et Microbiologica Scandinavica 1968, 74: 371–380.

    PubMed  Google Scholar 

  11. George, W. L., Sutter, V. L., Citron, D., Finegold, S. M. Selective and differential medium for isolation ofClostridium difficile. Journal of Clinical Microbiology 1979, 9: 214–219.

    PubMed  Google Scholar 

  12. Holdeman, L. V., Cato, E. P., Moore, W. E. C. Anaerobe Laboratory Manual. Virginia Polytechnic Institute and State University, Blacksburg, VA, 1977.

    Google Scholar 

  13. Aronsson, B., Möllby, R., Nord, C. E. Occurrence of toxin-producingClostridium difficile in antibiotic-associated diarrhea in Sweden. Medical Microbiology and Immunology 1981, 170: 27–35.

    PubMed  Google Scholar 

  14. Borriello, S. P., Barclay, F. E. An in-vitro model of colonisation resistance toClostridium difficile infection. Journal of Medical Microbiology 1986, 21: 299–309.

    PubMed  Google Scholar 

  15. Collignon, A., Cotte-Laffitte, J., Quero, A. M., Torlottin, J. C. Clostridium difficile et sa cytotoxine dans les selles de jeunes enfants hospitalisé. Influence du traitment antibiotique. Annals de Pédiatrie 1987, 34: 463–468.

    Google Scholar 

  16. Stark, P. L., Lee, A., Parsonage, B. D. Colonization of the large bowel byClostridium difficile in healthy infants: quantitative study. Infection and Immunity 1982, 35: 895–899.

    PubMed  Google Scholar 

  17. Krivan, H. C., Clark, G. F., Smith, D. F., Wilkins, T. D. Cell surface binding site forClostridium difficile enterotoxin: evidence for a glycoconjugate containing the sequence Galα1-3Galβ1-4GlcNAc. Infection and Immunity 1986, 53: 573–581.

    PubMed  Google Scholar 

  18. Cooperstock, M. S., Steffen, E., Yolken R., Onderdonk, A. Clostridium difficile in normal infants and in sudden infant death syndrome: an association with infant formula feeding. Pediatrics 1982, 70: 91–95.

    PubMed  Google Scholar 

  19. Boenning, D. A., Fleisher, G. R., Campos, J. M., Hulkower, C. W., Quinlan, R. W. Clostridium difficile in a pediatric outpatient population. Pediatric Infectious Diseases 1982, 1: 336–338.

    Google Scholar 

  20. Collignon, A., Chaumard, C., Torlottin, J. C. Implantation deClostridium difficile chez les nourrisons en cours d'antibiothérapie. Pathological Biology 1987, 35: 590–594.

    Google Scholar 

  21. Richardson, S. A., Alcock, P. A., Gray, J. Clostridium difficile and its toxin in healthy neonates. British Medical Journal 1983, 287: 878.

    PubMed  Google Scholar 

  22. Poxton, I. R., Aronsson, B., Möllby, R., Nord, C. E., Collee, J. G. Immunochemical fingerprinting ofClostridium difficile strains isolated from an outbreak of antibiotic associated colitis and diarrhoea. Journal of Medical Microbiology 1984, 17: 317–324.

    PubMed  Google Scholar 

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Tullus, K., Aronsson, B., Marcus, S. et al. Intestinal colonization withClostridium difficile in infants up to 18 months of age. Eur. J. Clin. Microbiol. Infect. Dis. 8, 390–393 (1989). https://doi.org/10.1007/BF01964052

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