Longitudinal investigation of carriage rates, counts, and genotypes of toxigenic Clostridium difficile in early infancy

Hiroyuki Kubota*, Hiroshi Makino, Agata Gawad, Akira Kushiro, Eiji Ishikawa, Takafumi Sakai, Takuya Akiyama, Kazunori Matsuda, Rocio Martin, Jan Knol, Kenji Oishi

*Corresponding author for this work

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7 Citations (Scopus)

Abstract

Asymptomatic infant carriers of toxigenic Clostridium difficile are suggested to play a role in the transmission of C. difficile infection (CDI) in adults. However, the mode of C. difficile carriage in infants remains to be fully elucidated. We investigated longitudinal changes in carriage rates, counts, and strain types of toxigenic C. difficile in infants. Stools collected from 111 healthy infants in Belgium periodically from birth until the age of 6 months were examined by quantitative PCR targeting 16S rRNA and toxin genes. Toxigenic C. difficile was detected in 18 of 111 infants (16%) in the period up to the age of 6 months. The carriage rate of toxigenic C. difficile remained below 5% until the age of 3 months. The carriage rate increased to 13% 1 week after weaning (average age, 143 days) and reached 16% at the age of 6 months. Counts of toxigenic C. difficile bacteria ranged from 104 to 108 cells/g of stool. Notably, two infants retained >108 cells/g of stool for at least several weeks. Average counts in the 18 infants hovered around 107 cells/g of stool from the age of 3 days until the age of 6 months, showing no age-related trend. Genotyping of toxigenic C. difficile isolates from the 18 infants revealed that 11 infants each retained a particular monophyletic strain for at least a month. The genotype most frequently identified was the same as that frequently identified in symptomatic adult CDI patients. Thus, toxigenic C. difficile strains-potential causes of CDI in adults-colonized the infants' intestines.

Original languageEnglish
Pages (from-to)5806-5814
JournalApplied and Environmental Microbiology
Volume82
Issue number19
DOIs
Publication statusPublished - 2016

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    Kubota, H., Makino, H., Gawad, A., Kushiro, A., Ishikawa, E., Sakai, T., Akiyama, T., Matsuda, K., Martin, R., Knol, J., & Oishi, K. (2016). Longitudinal investigation of carriage rates, counts, and genotypes of toxigenic Clostridium difficile in early infancy. Applied and Environmental Microbiology, 82(19), 5806-5814. https://doi.org/10.1128/AEM.01540-16