1887

Abstract

Summary

Faecal samples from 123 infants who died with sudden infant death syndrome (SIDS) and from a comparative group of 52 age-matched babies were analysed for toxigenic bacteria and their toxins. Serum samples from the SIDS infants were also analysed for these toxins. A significantly higher proportion of toxigenic bacteria and their toxins were found in faecal samples of SIDS babies than in samples from the comparative group. These toxins were also found in serum from the SIDS babies. was found in 54 (45·4%) of 119 SIDS cases compared with 10 (19·6%) of 51 healthy babies (χ = 10·1, p < 0·01); in 33 (27·7%) of 119 SIDS cases compared with 8 (14·8%) of 54 healthy babies (χ = 3·43, p < 0·1); in 12 (27·3%; 66·7% enterotoxigenic) of 44 SIDS cases compared with 12 (85·7%; non-enterotoxigenic) of 14 healthy babies (χ = 14·9, p < 0·001); in 6(5·0%) of 120 SIDS cases compared with 0 of 53 healthy babies (χ = 2·74, p < 0·1). salmonellae and were not detected. Heat-labile toxin, lethal to mice (HLML) was found in 32 (27·1%) of 118 SIDS faecal samples compared with 5 (10·6%) of 47 healthy babies (χ = 5·24, p < 0·05); cytotoxins in 38 (30·9%) of 123 SIDS faecal samples compared with 0 of 21 of healthy babies (χ = 8·8, p < 0·01) and 24 (27·6%) of 87 SIDS serum samples. enterotoxin was detected in 33 (34·4%) of 96 SIDS faecal extracts compared with 0 of 23 of healthy babies (χ = 10·94, p < 0·001), and in 27 (24·5%) of 110 SIDS serum samples. α-toxin (presumptive) was detected in 14 (17·5%) of 80 SIDS faecal extracts compared with 0 of 17 from healthy babies (χ = 3·5, p < 0·05) and in 2 (2·3%) of 87 SIDS serum samples. toxin was detected in four SIDS faecal samples and two serum samples. toxin was detected in only one of 120 SIDS faecal samples compared with none of 49 from healthy babies. Staphylococcal enterotoxins were detected in 8 (19·5%) of 41 SIDS faecal samples compared with 0 of 19 from healthy babies (χ = 4·278, p < 0·05), and in 4 (10·8%) of 37 SIDS serum samples. Toxigenic and non-toxigenic strains of and occurred in faecal samples of both SIDS and healthy babies. Formula-fed SIDS babies had a significantly higher incidence of = 6·654, p < 0·01), = 6·422, p < 0·05), and its enterotoxin (χ = 7·787, p < 0·01) in faeces, and a higher incidence (non-significant) of enterotoxin in their serum, faecal HLML toxin, and and its enterotoxin, than breast-fed babies. Male SIDS babies had a significantly higher incidence of = 7·687, p < 0·01) and higher incidences (non-significant) of enterotoxin, HLML toxin, and and its enterotoxin than female babies. SIDS babies dying in winter had a significantly higher incidence of than those dying in summer (χ = 5·328, p < 0·05) and spring (χ = 4·444, p < 0·05). and their enterotoxins occurred in more babies dying in autumn and winter than in spring and summer. The incidence of these bacteria and their toxins did not differ for position of death. These results provide some support for the idea that intestinal toxins have a pathogenic role in SIDS.

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/content/journal/jmm/10.1099/00222615-39-2-114
1993-08-01
2019-10-19
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http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/00222615-39-2-114
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