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Published on: February 14, 2020
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Natural Clostridioides difficile Toxin Immunization in Colonized Infants.
Larry K Kociolek1,2, Robyn O Espinosa2, Dale N Gerding3,4
1Department of Pediatrics, Northwestern University Feinberg School of Medicine.
Summary
Infant colonization with toxigenic Clostridioides difficile (TCD) triggers an immune response, increasing antibodies against TCD toxins A and B. This natural exposure may offer future protection against C. difficile infection (CDI).
Area of Science:
- Microbiology
- Immunology
- Pediatrics
Background:
- Infant colonization with Clostridioides (Clostridium) difficile is common.
- The serological consequences of infant C. difficile colonization are not well understood.
Purpose of the Study:
- To investigate the serological sequelae of toxigenic C. difficile (TCD) colonization in infants.
- To assess the development of antibodies against TCD toxins and their neutralizing capacity.
Main Methods:
- Prospective cohort study of healthy infants from 1-12 months.
- Serial stool sample testing for TCD, followed by whole-genome sequencing of isolates.
- Measurement of serum IgA, IgG, IgM against TCD toxins A and B, and neutralizing antibody (NAb) titers against toxin B at 9-12 months.
- Comparison with serum from unrelated mothers (cord blood).
Main Results:
- 50% of infants were colonized with TCD; transmission occurred within households and clinics.
- Infants colonized with TCD >1 month prior showed significantly higher serum antitoxin IgA and IgG against toxins A and B.
- 42% of colonized infants developed detectable NAb titers against toxin B, compared to none in non-colonized infants.
- Breastfeeding did not influence serological measurements.
Conclusions:
- TCD colonization in infants is associated with a robust humoral immune response, including antibody production against toxins A and B.
- Evidence suggests in vitro neutralization of toxin B by antibodies developed post-colonization.
- Further research is needed to determine the long-term protective effects against C. difficile infection (CDI) from natural C. difficile immunization events.
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