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A widely-used dietary sugar enhances the virulence of the bacterium Clostridium difficile, the most common healthcare-associated infection, according to new research published in Nature.

C. difficile is a major cause of infectious disease-related deaths in the U.S., according to the CDC. In 2015, the bacterium caused almost a half million infections and 29,000 deaths. Most infections occur in people who have received medical care and antibiotics and the elderly are at the highest risk of infection.

Currently, the two most common lineages of C. difficile to infect people are RT027 and RT078. Both lineages are resistant to the antibiotic, fluoroquinolone.

In an effort to combat these lineages, the research team wanted to learn what sources of food the two strains preferred. They found that, compared to other lineages, RT027 and RT078 could grow on extremely low levels of the sugar, trehalose.

Trehalose is a widely-used food additive used in everything from sushi to ice cream.

To further investigate, the researchers fed laboratory mice with the RT027 lineage of C. difficile either a diet with low levels of trehalose or one without the dietary sugar.

The results showed that disease severity was directly linked to the presence of trehalose in their diet. The researchers believe that trehalose causes RT027 to produce higher levels of toxins.

"Our work suggests that trehalose may have contributed to not only the rise of the superbugs but also the severity of disease.  We hope that a clinical study will ensue soon to study the impact of trehalose limitation on C. difficile disease incidence and severity.  If our hypothesis is correct then hopefully limiting trehalose during RT027 and RT078 outbreaks would provide better outcomes for patients," corresponding author Dr. Robert Britton, professor of molecular virology and microbiology and member of the Alkek Center for Metagenomics and Microbiome Research and the Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine, told ALN.

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