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.
摘要：
抗生素使用与艰难梭菌之间的关系(C.difficile）已在成人和年龄较大的儿童中得到很好的确立，但仍不清楚，尚未在婴儿人群中进行全面检查。本研究旨在确定抗生素和家用清洁产品对婴儿艰难梭菌定植的单独和累积影响。这项研究包括加拿大健康婴儿纵向发育（CHILD）出生队列中的1429名3-4个月大的婴儿和1728名12个月大的婴儿。从医院出生图和标准化问卷中获得婴儿抗菌药物暴露水平。通过Illumina16S核糖体核糖核酸(rRNA)基因测序来表征婴儿肠道微生物群。使用定量聚合酶链反应(qPCR)进行艰难梭菌的分析。总的来说,艰难梭菌在3-4个月和12个月时定植了31％和46％的婴儿，分别。在3-4个月，艰难梭菌定植在同时暴露于抗生素和较高(高于平均水平)家庭清洁产品(调整比值比(aOR)1.50,95%CI1.03-2.17;p=0.032)的婴儿中显著高于暴露于最少抗菌药物的婴儿。这种较高的定植持续到12个月大。我们的研究表明，累积暴露于全身抗生素和家庭清洁产品的较高使用率会促进婴儿艰难梭菌定植。需要进一步的研究来了解未来的健康影响。
