title: Intestinal colonization with Clostridium difficile in infants up to 18 months of age.
abstract: The faecal colonization with Clostridium 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 with Clostridium 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 with Clostridium difficile than were bottle-fed infants, both at 6 weeks of age (21% versus 47%, p less than 0.05) and at 6 months of age (19% versus 39%, p less than 0.001). Colonization with Clostridium 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 less than 0.05). This association was even more pronounced when the bacteria persisted at 11 months of age (54%, p less than 0.01). Antibiotic therapy could not be demonstrated to influence colonization with Clostridium difficile at any age.
authors.affiliation: Department of Pediatrics, Danderyd Hospital, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Tullus
authors.forename: B
authors.initials: B
authors.lastname: Aronsson
authors.forename: S
authors.initials: S
authors.lastname: Marcus
authors.forename: R
authors.initials: R
authors.lastname: Möllby
mesh_terms: D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins; D001427:Bacterial Toxins / Q000096:biosynthesis; D001942:Breast Feeding; D003013:Clostridium / Q000254:growth & development* / Q000302:isolation & purification / Q000378:metabolism; D003967:Diarrhea / Q000453:epidemiology; D005243:Feces / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007422:Intestines / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; C031815:toxB protein, Clostridium difficile