Allergy development and the intestinal microflora during the first year oflife

Background: The intestinal microflora is a likely source for the induction of immune deviation in infancy. Objective: The purpose of this study was to prospectively relate the intest inal microflora to allergy development in 2 countries differing with respec t to the prevalence of atopic diseases. Methods: Newborn infants were followed prospectively through the first 2 ye ars of life in Estonia (n = 24) and Sweden (n = 20). By that age, 9 Estonia n and 9 Swedish infants had developed atopic dermatitis and/or positive ski n prick test results. Stool samples were obtained at 5 to 6 days and at 1, 3, 6, and 12 months, and 13 groups of aerobic and anaerobic microorganisms were cultivated through use of standard methods. Results: In comparison with healthy infants, babies who developed allergy w ere less often colonized with enterococci during the first month of life (7 2 % vs 96 %; P < .05) and with bifidobacteria during the first year of life (17 % to 39 % vs 42 % to 69 %; P < .05). Furthermore, allergic infants had higher counts of clostridia at 3 months (median value, 10.3 vs 7.2 log(10) ; P < .05). The prevalence of colonization with Staphylococcus aureus was a lso higher at 6 months (61 % vs 23 %; P < .05), whereas the counts of Bacte roides were lower at 12 months (9.9 vs 10.6 log(10); P < .05). Conclusion: Differences in the composition of the gut flora between infants who will and infants who will not develop allergy are demonstrable before the development of any clinical manifestations of atopy. Because the observ ations were made in 2 countries with different standards of living, we beli eve that our findings could indicate a role for the intestinal microflora i n the development of and protection from allergy.