We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Natural Clostridioides difficile Toxin Immunization in Colonized Infants.
- Authors
Kociolek, Larry K; Espinosa, Robyn O; Gerding, Dale N; Hauser, Alan R; Ozer, Egon A; Budz, Maria; Balaji, Aakash; Chen, Xinhua; Tanz, Robert R; Yalcinkaya, Nazli; Conner, Margaret E; Savidge, Tor; Kelly, Ciaran P
- Abstract
Background Clostridioides (Clostridium) difficile colonization is common among infants. Serological sequelae of infant C. difficile colonization are poorly understood. Methods In this prospective cohort study of healthy infants, stools serially collected between ages 1-2 and 9-12 months were tested for non-toxigenic and toxigenic C. difficile (TCD). Cultured isolates underwent whole-genome sequencing. Serum collected at 9–12 months underwent measurement of IgA, IgG, and IgM against TCD toxins A and B and neutralizing antibody (NAb) titers against toxin B. For comparison, antitoxin IgG and NAb were measured in cord blood from 50 mothers unrelated to study infants. Results Among 32 infants, 16 (50%) were colonized with TCD; 12 were first colonized >1 month before serology measurements. A variety of sequence types were identified, and there was evidence of putative in-home (enrolled siblings) and outpatient clinic transmission. Infants first colonized with TCD >1 month prior had significantly greater serum antitoxin IgA and IgG against toxins A (P =.02 for both) and B (P =.009 and.008, respectively) compared with non–TCD-colonized infants, and greater IgG compared with unrelated cord blood (P =.005). Five of 12 (42%) colonized infants had detectable NAb titers compared with zero non–TCD-colonized infants (P =.02). Breastfeeding was not associated with differences in serological measurements. Conclusions TCD colonization is associated with a humoral immune response against toxins A and B, with evidence of toxin B neutralization in vitro. The extent and duration of protection against CDI later in life afforded by natural C. difficile immunization events require further investigation.
- Subjects
ANTITOXINS; CLOSTRIDIOIDES difficile; CLOSTRIDIUM diseases; HOST-bacteria relationships; IMMUNIZATION; IMMUNOGLOBULINS; LONGITUDINAL method; SEQUENCE analysis; CHILDREN
- Publication
Clinical Infectious Diseases, 2020, Vol 79, Issue 10, p2095
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciz582