Bolton R P, Tait S K, Dear P R, Losowsky M S
Arch Dis Child. 1984 May;59(5):466-72. doi: 10.1136/adc.59.5.466.
In a prospective survey of infants born in a single maternity unit, asymptomatic faecal colonisation by Clostridium difficile occurred in 31 (47%) of 66 babies who provided a faecal sample during week one of life and at age 14 and 28 days, and in 46 (30.7%) of the total of 150 babies for whom at least one faecal sample was obtained during the month of study. There was no evidence for acquisition of the organism from the mother during delivery and colonisation was unrelated to the means of delivery, infant sex, means of feeding, duration of hospital stay, or antibiotic treatment. New colonisation occurred throughout the month of the study and further evidence for environmental acquisition was obtained by the finding of a similar strain of C difficile in 7 babies from one ward together with positive environmental cultures. Colonisation was frequently transient and occasionally intermittent; most infants kept the same strain during their period of carriage. Twenty two (47.8%) babies colonised by C difficile had low titres of cytopathic faecal toxin but none had symptomatic diarrhoea or features of necrotizing enterocolitis. The in vitro toxigenic potential of 57 toxigenic isolates from 36 babies was low and 12 babies carried non-toxigenic strains. Transient colonisation by C difficile in early life is almost certainly more common than is generally recognized and the neonate provides an important reservoir of potential infection.
在一项针对在单一产科病房出生的婴儿的前瞻性调查中，在出生第一周、14天和28天时提供粪便样本的66名婴儿中，有31名（47%）无症状粪便被艰难梭菌定植；在研究当月至少获取过一次粪便样本的150名婴儿中，有46名（30.7%）被定植。没有证据表明婴儿在分娩过程中从母亲那里获得该病菌，定植与分娩方式、婴儿性别、喂养方式、住院时间或抗生素治疗无关。在研究当月期间均有新的定植发生，并且通过在一个病房的7名婴儿中发现相似的艰难梭菌菌株以及环境培养呈阳性，进一步证明了环境获得该病菌。定植通常是短暂的，偶尔是间歇性的；大多数婴儿在携带病菌期间保持相同的菌株。22名（47.8%）被艰难梭菌定植的婴儿粪便细胞毒素滴度较低，但均无症状性腹泻或坏死性小肠结肠炎的特征。从36名婴儿中分离出的57株产毒菌株的体外产毒潜力较低，12名婴儿携带无毒菌株。早年由艰难梭菌引起的短暂定植几乎肯定比普遍认为的更为常见，并且新生儿是潜在感染的重要储存宿主。
