Antibodies to Clostridium difficile Cytotoxin in a Pediatric Population

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Abstract
Sir.—We read with interest the article "Clostridium difficileCytotoxin in a Pediatric Population" by Thompson et al (Journal1983;137:271-274). They give three hypotheses for the absence of gastrointestinal (GI) symptoms in infants with fecal toxin, with one being protection by maternal antibody. We have examined serum, from children of different ages and pregnant women, for the presence of neutralizing antibodies toC difficilecytotoxin, and we report our findings. Tests were performed by a microtiter technique used in a previous report from our laboratory.1A broth culture ofC difficilewas tested for its toxin titer against Hela cells and was diluted to give 4 cytopathic units (CPUs) of toxin when added to tissue cultures. We defined 1 CPU of toxin as the amount that causes morphologic changes in greater than 90% of cells. Serum was incubated at room temperature for 30 minutes with an equal volume of

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