Toxin-producing bacteria in infants. Lack of an association with sudden infant death syndrome
M. J. Gurwith, C. Langston and D. M. Citron
After finding enterotoxigenic (ET) Escherichia coli in two consecutive
cases of sudden infant death syndrome (SIDS), we initiated a prospective
search for ET E coli in SIDS in Manitoba; in addition, we looked for
toxigenic Clostridium botulinum and C difficile. In a 21-month period,
small- and large-bowel contents were obtained in 33 cases of SIDS, from 32
control subjects, and in ten suspected cases of SIDS. Neither C botulinum
nor ET E coli was isolated from any of these; C difficile was cultured from
postmortem bowel contents of two SIDS and seven control cases. The overall
isolation rate of C difficile was 17%. Despite the fact that two of these
cases had toxin detectable in the bowel contents, no evidence of colitis
was found in any of the cases with C difficile. We conclude that C
botulinum or ET E coli have only a small role, if any, in the etiology of
SIDS, and that C difficile is found relatively commonly in the
gastrointestinal tract of infants without apparent local or systemic
effects.
