title: High fecal IgA is associated with reduced Clostridium difficile colonization in infants.
abstract: Colonization of infants with Clostridium difficile is on the rise. Although better tolerated by infants than adults, it is a risk factor for future allergic disease. The present study describes associations between infant fecal immunoglobulin A (IgA) and colonization with C. difficile in 47 infants enrolled in the Canadian Healthy Infant Longitudinal Development (CHILD) study. C. difficile colonization was observed in over half (53%) of the infants. Median IgA was lower in infants colonized with C. difficile (10.9 μg versus 25.5 μg per g protein; p = 0.18). A smaller proportion of infants with IgA in the highest tertile were colonized with C. difficile compared to the other tertiles (31.3% versus 64.5%, p = 0.03). In unadjusted analysis, odds of colonization with C. difficile was reduced by 75% (OR 0.25 95% CI 0.07, 0.91 p = 0.04) among infants with IgA in the highest tertile compared to those in the other tertiles. Following adjustment for parity, birth mode and breastfeeding, this association was even stronger (aOR 0.17, 95% CI 0.03, 0.94, p = 0.04). Our study provides evidence that high fecal IgA, independent of breastfeeding, is associated with reduced likelihood of C. difficile colonization in infancy.
authors.affiliation: Department of Pediatrics, University of Alberta, AB, Canada.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Bridgman
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, ON, Canada.
authors.forename: Tedd
authors.initials: T
authors.lastname: Konya
authors.affiliation: Department of Pediatrics, University of Alberta, AB, Canada; Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, MB, Canada.
authors.forename: Meghan B
authors.initials: MB
authors.lastname: Azad
authors.affiliation: Centre for the Analysis of Genome Evolution and Function, University of Toronto, ON, Canada.
authors.forename: David S
authors.initials: DS
authors.lastname: Guttman
authors.affiliation: Department of Medicine, de Groote School of Medicine, McMaster University, ON, Canada.
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Sears
authors.affiliation: Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, MB, Canada.
authors.forename: Allan B
authors.initials: AB
authors.lastname: Becker
authors.affiliation: Department of Pediatrics, Child & Family Research Institute and BC Children's Hospital, University of British Columbia, BC, Canada.
authors.forename: Stuart E
authors.initials: SE
authors.lastname: Turvey
authors.affiliation: Department of Pediatrics, University of Alberta, AB, Canada.
authors.forename: Piush J
authors.initials: PJ
authors.lastname: Mandhane
authors.affiliation: Department of Pediatrics, Hospital for Sick Children, University of Toronto, ON, Canada.
authors.forename: Padmaja
authors.initials: P
authors.lastname: Subbarao
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, ON, Canada.
authors.forename: James A
authors.initials: JA
authors.lastname: Scott
authors.affiliation: Agriculture, Food and Nutritional Sciences, University of Alberta, AB, Canada.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Field
authors.affiliation: Department of Pediatrics, University of Alberta, AB, Canada. Electronic address: kozyrsky@ualberta.ca.
authors.forename: Anita L
authors.initials: AL
authors.lastname: Kozyrskyj
mesh_terms: D002170:Canada / Q000453:epidemiology; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D016360:Clostridioides difficile / Q000276:immunology*; D003015:Clostridium Infections / Q000453:epidemiology* / Q000382:microbiology*; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis*; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male
chemical_list: D007070:Immunoglobulin A
keywords: Clostridium difficile; Immunoglobulin A; Infant