Clostridium difficile, atopy and wheeze during the first year of life

Differences have been suggested to occur in the composition of intestinal microflora from allergic and non-allergic children. In this study we used a semi-quantitative enzyme-linked immunosorbent assay ( ELISA) for the measurement of Clostridium difficile-specific immunoglobulin G(IgG) (CDIgG). CDIgG was excellent in differentiating between adults with or without Cl. difficile colitis ( absorbance levels, positive vs. negative controls: geometric mean (GM) 0.301, 95% CI: 0.289-0.314 vs. GM 0.167, 95% CI: 0.155-0.181; mean difference 1.8-fold, 95% CI: 1.65-1.95; p<0.0001). We used this technique to investigate whether there are any differences between atopic wheezy infants and non-atopic non-wheezy controls. In a prospective cohort study (n=390) 10 patients were identified at 1 year of age ( atopic, history of recurrent wheeze) and matched(gender, month of birth, exposure to Derp1, Feld1 and Canf1) with a control group of infants( non-atopic, no history of wheeze). The patients had significantly higher Cl. difficile-specific IgG absorbance levels ( GM 0.298, 95% CI: 0.249-0.358) compared with controls (GM 0.235, 95% CI: 0.201-0.274; mean difference 1.27-fold, 95% CI: 1.07-1.50; p= 0.01). These results suggest that there may be differences in the composition of intestinal microflora between allergic and non-allergic infants at 1 year of age, with allergic children having higher Cl. difficile IgG antibody levels.