High fecal IgA is associated with reduced Clostridium difficile colonization in infants

Sarah L Bridgman; Tedd Konya; Meghan B Azad; David S Guttman; Malcolm R Sears; Allan B Becker; Stuart E Turvey; Piush J Mandhane; Padmaja Subbarao; CHILD Study Investigators; James A Scott; Catherine J Field; Anita L Kozyrskyj

doi:10.1016/j.micinf.2016.05.001

High fecal IgA is associated with reduced Clostridium difficile colonization in infants

Microbes Infect. 2016 Sep;18(9):543-9. doi: 10.1016/j.micinf.2016.05.001. Epub 2016 May 24.

Affiliations

¹ Department of Pediatrics, University of Alberta, AB, Canada.
² Dalla Lana School of Public Health, University of Toronto, ON, Canada.
³ Department of Pediatrics, University of Alberta, AB, Canada; Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, MB, Canada.
⁴ Centre for the Analysis of Genome Evolution and Function, University of Toronto, ON, Canada.
⁵ Department of Medicine, de Groote School of Medicine, McMaster University, ON, Canada.
⁶ Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, MB, Canada.
⁷ Department of Pediatrics, Child & Family Research Institute and BC Children's Hospital, University of British Columbia, BC, Canada.
⁸ Department of Pediatrics, Hospital for Sick Children, University of Toronto, ON, Canada.
⁹ Agriculture, Food and Nutritional Sciences, University of Alberta, AB, Canada.
¹⁰ Department of Pediatrics, University of Alberta, AB, Canada. Electronic address: kozyrsky@ualberta.ca.

PMID: 27235197
DOI: 10.1016/j.micinf.2016.05.001

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.

Keywords: Clostridium difficile; Immunoglobulin A; Infant.

MeSH terms

Canada / epidemiology
Carrier State / epidemiology*
Carrier State / microbiology*
Clostridioides difficile / immunology*
Clostridium Infections / epidemiology*
Clostridium Infections / microbiology*
Feces / chemistry*
Female
Humans
Immunoglobulin A / analysis*
Infant
Infant, Newborn
Longitudinal Studies
Male

Substances

Immunoglobulin A

Grants and funding

227312/CIHR/Canada