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Table 1.

Hygiene practices understood to negatively affect human ecology

ChangeConsequence
Clean water Reduced fecal transmission 
Increase in cesarean sections Reduced vaginal transmission 
Increased use of preterm antibiotics Reduced vaginal transmission 
Reduced breastfeeding Reduced cutaneous transmission and changed immunological environment 
Smaller family size Reduced early life transmission 
Widespread antibiotic use Selection for changing composition 
Increased bathing, showering, and use of antibacterial soaps Selection for changing composition 
ChangeConsequence
Clean water Reduced fecal transmission 
Increase in cesarean sections Reduced vaginal transmission 
Increased use of preterm antibiotics Reduced vaginal transmission 
Reduced breastfeeding Reduced cutaneous transmission and changed immunological environment 
Smaller family size Reduced early life transmission 
Widespread antibiotic use Selection for changing composition 
Increased bathing, showering, and use of antibacterial soaps Selection for changing composition 

Source: Adapted from Blaser and Falkow 2009, 889.

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