Author Interviews, C. difficile, Pediatrics / 07.08.2019
C. difficile Exposure During Infancy May Protect Against Later Infections
MedicalResearch.com Interview with:
Larry K. Kociolek, MD MSCI
Attending Physician, Division of Infectious Diseases,
Associate Medical Director of Infection Prevention and Control,
Ann & Robert H. Lurie Children’s Hospital of Chicago
Assistant Professor of Pediatrics
Northwestern University Feinberg School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Clostridioides (Clostridium) difficile colonization is very common among infants, yet infants almost never develop symptoms of infection. In adults, it is known that immunity against the toxins that C. difficile produces protect against C. difficile infection (CDI).
Our goal was to determine whether or not infants who become colonized with C. difficile develop an immune response against these toxins. We collected stool from healthy infants at multiple time points during the first year of life to determine whether or not they became colonized with C. difficile. Then at 9-12 months old, we collected blood to see if we can identify antibodies in their blood that protect against these toxins.
We discovered that colonization with C. difficile during infancy was strongly associated with the development of antibodies. These antibodies were able to protect against the harmful effects of these toxins in a laboratory cell culture model.
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Kathryn M. Edwards, M.D.
Sarah H. Sell and Cornelius Vanderbilt Chair in Pediatrics
Professor of Pediatrics
Vanderbilt University School of Medicine
Dr. Edwards discusses the statement from the Infectious Diseases Society of America (IDSA) regarding the Centers for Disease Control and Prevention’s new data on child vaccine rates across the United States.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: To monitor the uptake of vaccines the CDC conducts a National Immunization Survey each year. This survey is conducted by random-digit dialing (cell phones or landlines) of parents and guardians of children 19-35 months of age. The interviewers ask the families who provides the vaccines for their children and if these providers can be contacted to inquire about the immunizations received. The overall response rate to the telephone survey was 26% and immunization records were provided on 54% of the children where permission was granted. Overall 15, 333 children had their immunization records reviewed.
When comparing immunization rates for 2017 and 2016, the last two years of the study, several new findings were discovered.
First the overall coverage rate for 3 doses of polio vaccine, one dose of MMR, 3 doses of Hepatitis b, and 1 dose of chickenpox vaccine was 90%, a high rate of coverage. Children were less likely to be up to date on the hepatitis A vaccine (70%) and rotavirus vaccine (73%). Coverage was lower for children living in rural areas when compared with urban areas and children living in rural areas had higher percentages of no vaccine receipt at all (1.9%) compared with those living in urban areas (1%).
There were more uninsured children in 2017 at 2.8% and these children had lower immunization rates. In fact 7.1% of the children with no insurance were totally unimmunized when compared with 0.8% unimmunized in those with private insurance. Vaccine coverage varies by state and by vaccine.