Early Life Antimicrobial Exposure: Impact on Clostridioides difficile Colonization in Infants

Abstract

The relationship between antibiotic use and Clostridioides difficile (C. difficile) has been well established in adults and older children but remains unclear and is yet to be fully examined in infant populations. This study aimed to determine the separate and cumulative impact from antibiotics and household cleaning products on C. difficile colonization in infants. This study included 1429 infants at 3–4 months of age and 1728 infants at 12 months of age from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. The levels of infant antimicrobial exposure were obtained from hospital birth charts and standardized questionnaires. Infant gut microbiota was characterized by Illumina 16S ribosomal ribonucleic acid (rRNA) gene sequencing. Analysis of C. difficile was performed using a quantitative polymerase chain reaction (qPCR). Overall, C. difficile colonized 31% and 46% of infants at 3–4 months and 12 months, respectively. At 3–4 months, C. difficile colonization was significantly higher in infants exposed to both antibiotics and higher (above average) usage of household cleaning products (adjusted odds ratio (aOR) 1.50, 95% CI 1.03–2.17; p = 0.032) than in infants who had the least antimicrobial exposure. This higher colonization persisted up to 12 months of age. Our study suggests that cumulative exposure to systemic antibiotics and higher usage of household cleaning products facilitates C. difficile colonization in infants. Further research is needed to understand the future health impacts.

Perinatal and early life factors and asthma control among preschoolers: a population-based retrospective cohort study

“…C-section birth increases the susceptibility to early childhood asthma26 which is suggested to be due to an underdeveloped gut microbiota composition in the infant 27 28. Antibiotic use during pregnancy29 and early childhood30 are also known to disrupt the composition of the gut microbiota in children. We found that antibiotic use in early childhood appears to have a larger impact on asthma disease programming than fetal exposure: in our cohort of children with asthma, maternal antibiotic use during pregnancy was associated with a slight increase in the risk of partly controlled asthma (aRR: 1.11); however, we saw a higher likelihood of uncontrolled asthma in children who had antibiotics dispensed between 30 days of life and prior to their asthma diagnosis (aRR: 1.32).…”