Asymptomatic carriage of Clostridium difficile and serum levels of IgG antibody against toxin A.
Asymptomatic carriage of Clostridium difficile and serum levels of IgG antibody against toxin A.
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DOI：
10.1056/nejm200002103420604
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发表时间：
2000-02-10
影响因子：
158.5
通讯作者：
Kelly, CP
中科院分区：
文献类型：
--
作者：
Kyne, L;Warny, M;Kelly, CP
背景：艰难梭菌感染可导致无症状携带、轻度腹泻或暴发性假膜性结肠炎。我们研究了抗体是否对C。艰难梭菌毒素影响定植、腹泻和无症状携带的风险。正在接受抗生素治疗的住院患者中的艰难感染。连续粪便样本进行C。艰难梭菌定植通过细胞毒素测定和培养。血清抗体（伊加、IgG和IgM）水平和粪便抗体（伊加和IgG）水平。采用酶联免疫吸附试验（ELISA）检测艰难梭菌毒素A、毒素B和非毒素抗原。入院时为艰难梭菌携带者，其中18人为无症状携带者。另有47名患者（17%）在医院感染，其中19人无症状。后来被殖民的患者和没有被殖民的患者的基线抗体水平相似。定植后，那些成为无症状携带者的患者血清中抗毒素A的IgG抗体水平显著高于C。发生艰难梭菌性腹泻（P
Background: Clostridium difficile infection can result in asymptomatic carriage, mild diarrhea, or fulminant pseudomembranous colitis. We studied whether antibody responses to C. difficile toxins affect the risks of colonization, diarrhea, and asymptomatic carriage.Methods: We prospectively studied C. difficile infections in hospitalized patients who were receiving antibiotics. Serial stool samples were tested for C. difficile colonization by cytotoxin assay and culture. Serum antibody (IgA, IgG, and IgM) levels and fecal antibody (IgA and IgG) levels against C. difficile toxin A, toxin B, and nontoxin antigens were measured by an enzyme-linked immunosorbent assay (ELISA).Results: Of 271 patients, 37 (14 percent) were colonized with C. difficile at the time of admission, 18 of whom were asymptomatic carriers. An additional 47 patients (17 percent) became infected in the hospital, 19 of whom remained asymptomatic. The base-line antibody levels were similar in the patients who later became colonized and those who did not. After colonization, those who became asymptomatic carriers had significantly greater increases in serum levels of IgG antibody against toxin A than did the patients in whom C. difficile diarrhea developed (P