CLOSTRIDIUM-PERFRINGENS TYPE-A CYTOTOXIC-ENTEROTOXIN(S) AS TRIGGERS FOR DEATH IN THE SUDDEN-INFANT-DEATH-SYNDROME - DEVELOPMENT OF A TOXICO-INFECTION HYPOTHESIS

In our studies with the pathogenic bacterium Clostridium perfringens t ype A and its cytotoxic-enterotoxins (CTEs), we have obtained results that imply an involvement of this organism in the sudden infant death syndrome (SIDS). In fecal samples obtained from SIDS infants (n = 164) and non-SIDS infants (n = 57), C. perfringens type A was present in h igh numbers in >80% of SIDS and <2% of control non-SIDS cases respecti vely. Fecal samples from SIDS infants analyzed by ELISA for C. perfrin gens type A CTEs showed a very strong positive correlation with the pr esence of the organism. Histopathological examination of ileal tissue from SIDS infants showed remarkable similarity to tissue from animal m odels affected by C. perfringens type A CTEs, where the patterns of da mage were positively correlated with the age of the animal. We propose that systemic distribution of the CTEs acts parasympathomimetically t o trigger a biochemical cascade that alters cardiorespiratory control. Death may subsequently ensue in an immunologically vulnerable infant.