Clostridium perfringens type A cytotoxic-enterotoxin(s) as triggers for death in the sudden infant death syndrome: Development of a toxico-infection hypothesis

Lindsay, James; Mach, Annette; Wilkinson, Melissa A.; Martin, L. Michele; Wallace, F. Morgan; Keller, Andreas M.; Wojciechowski, Lisa M.

doi:10.1007/bf01576834

Cited by 51 publications

(23 citation statements)

References 40 publications

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“…Many SIDS infants have symptoms of gastrointestinal infections prior to death, and compared to healthy infants in the same age range, toxigenic strains of Clostridium perfringens are more likely to be identified in SIDS infants [3]. A number of studies have found significantly higher levels of C. perfringens and their toxins in SIDS cases compared to non‐SIDS cases [4,5], and one study found C. perfringens in faeces from 45.4% of SIDS infants compared to 19.6% of healthy babies [5]. This study also found that formula fed SIDS infants had a significantly higher incidence of C. perfringens and its enterotoxin in their faeces than breast fed infants [5].…”

Section: Introductionsupporting

confidence: 56%

“…Significantly higher levels of C. perfringens and their toxins have been identified in SIDS cases compared to non‐SIDS cases [4,5], and formula fed infants had a significantly higher incidence of C. perfringens and its enterotoxin in their faeces than breast fed infants [5]. Compared with healthy infants, enterotoxigenic strains of S. aureus and their toxins have also been isolated significantly more often from the gastrointestinal tracts of SIDS infants.…”

Section: Discussionmentioning

confidence: 99%

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The protective effect of breast feeding in relation to sudden infant death syndrome (SIDS): II. The effect of human milk and infant formula preparations on binding ofClostridium perfringensto epithelial cells

Gordon

Saadi

MacKenzie

et al. 1999

FEMS Immunology &Amp; Medical Microbiology

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Breast feeding is known to protect an infant against gastrointestinal pathogens and epidemiological studies indicate that compared to breast fed infants, formula fed infants are at a greater risk of dying from sudden infant death syndrome (SIDS). Many SIDS infants have symptoms of gastrointestinal infections prior to death and one gastrointestinal pathogen associated with SIDS is Clostridium perfringens. Studies have found that a significantly higher number of formula fed SIDS infants have C perfringens and its enterotoxin in their faeces compared to breast fed infants. The aim of the study was to compare the effects of human milk and infant formula on binding of C perfringens to epithelial cells. Two protocols were used to assess the effect of human milk and infant formula to inhibit binding of C perfringens to epithelial cells. Binding was assessed by flow cytometry. For the in vivo protocol which more closely represents interactions on the mucosal surface, breast milk enhanced bacterial binding but infant formula caused inhibition of binding; however for the in vitro method, both human milk and infant formula resulted in consistent enhancement of binding. Flow cytometry studies indicated that enhancement of binding was due to the formation of bacterial aggregates. Lewis(a) and Lewis(b) antigens, found in both breast milk and infant formula, inhibited C. perfringens binding in a dose dependent manner. The Lewis(a) and Lewis(b) antigens in human milk and infant formula can inhibit C. perfringens binding to epithelial cells. While infant formula reduced binding of C. perfringens to epithelial cells in the experiments carried out with the in vivo protocol, the protective effects of breast feeding in relation to colonisation with C. perfringens are more likely to be due to formation of bacterial aggregates. These findings have implications for improving infant formula preparations.

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Section: Introductionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

The protective effect of breast feeding in relation to sudden infant death syndrome (SIDS): II. The effect of human milk and infant formula preparations on binding ofClostridium perfringensto epithelial cells

Gordon

Saadi

MacKenzie

et al. 1999

FEMS Immunology &Amp; Medical Microbiology

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show abstract

“…bacteriophage). [19] Other less common bacteria have also been investigated, and an association between SIDS and the presence of Clostridium perfringens in the intestinal tract of SIDS infants has been reported [34]. Moreover, Clostridium botulinum, which produces the most toxic protein known botulinum neurotoxin (BoNT), has been reported in SIDS infants [35].…”

Section: Viral Infection and Sidsmentioning

confidence: 98%

Infectious causes of sudden infant death syndrome

Alfelali

Khandaker

2014

Paediatric Respiratory Reviews

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“…perfringens type A cytotoxic enterotoxin (CTE) was detectable by ELISA coinciding with the presence of the organism. Furthermore, histopathological change to the SIDS infants’ ileal tissue showed remarkable similarity to animal models of CTE damage (Lindsay et al. 1993), and in rabbit models, CTE has been shown to contribute to intrathoracic petechiae, a pathological hallmark of SIDS (Siarakas et al.…”

Section: Enteric Bacteriamentioning

confidence: 99%

An infectious aetiology of sudden infant death syndrome

Highet

2008

Journal of Applied Microbiology

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Summary Due attention has been given to infectious agents and immune responses to infection in sudden infant death syndrome (SIDS). It has been acknowledged that the pathological, epidemiological and genotypic findings in SIDS infants suggest an infectious aetiology possibly being potentiated by immunoregulatory polymorphisms, however, the cause of SIDS is a mystery and remains open to debate. Consistent pathological findings are seen which display similarities to the pathogenesis of toxaemic shock and/or sepsis. The major risk factors for SIDS parallel those for increased colonization and serious bacterial infections and the natural variation in the incidence of SIDS cases is typical of an infectious disease. The roles played by viral infection, immunoregulatory genes and suspected bacterial species are discussed herein.

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Clostridium perfringens type A cytotoxic-enterotoxin(s) as triggers for death in the sudden infant death syndrome: Development of a toxico-infection hypothesis

Cited by 51 publications

References 40 publications

The protective effect of breast feeding in relation to sudden infant death syndrome (SIDS): II. The effect of human milk and infant formula preparations on binding ofClostridium perfringensto epithelial cells

The protective effect of breast feeding in relation to sudden infant death syndrome (SIDS): II. The effect of human milk and infant formula preparations on binding ofClostridium perfringensto epithelial cells

Infectious causes of sudden infant death syndrome

An infectious aetiology of sudden infant death syndrome

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