Study: sugar substitute the cause of increased severe diarrhea

Study: sugar substitute the cause of increased severe diarrhea

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Sugar substitute promotes the spread of dangerous diarrhea pathogens

In recent years, infections with the intestinal germ Clostridium difficile have increased dramatically worldwide. The pathogen plays a role particularly in hospital infections, but an increasing frequency of infections is also observed in the general population. Scientists have now presented a surprising explanation for the increase in the corresponding infections. Accordingly, the sugar substitute trehalose could play a significant role in the spread of particularly aggressive strains of the bacterium Clostridium difficile.

The research team led by Professor Dr. In his current study, Robert Britton from Baylor College of Medicine (USA) has linked the increasing number and the increasing severity of Clostridium difficile infections with trehalose. "C. Difficile infections have always been a problem in hospitals, but in the past 15 years they have become the most common cause of hospital-acquired infections in developed countries, ”said Prof. Britton. The sugar substitute could play a significant part in this. The researchers published their study results in the journal "Nature".

Severe diarrhea and life-threatening colon inflammation

The bacteria of the genus Clostridium difficile cause life-threatening inflammation of the colon and severe diarrhea in humans. “Patients aged 65 years and older are particularly at risk, and most infections occur in people who have received medical care and antibiotics,” the scientists report. In the United States, Clostridium difficile infections are a leading cause of death from infectious diseases, and in 2015, nearly half a million infections and 29,000 estimated deaths were reported, according to the Center for Disease Control and Prevention (CDC) , said the Baylor College of Medicine.

Two bacterial lines have become increasingly common

According to the scientists, they were able to determine that the “C. difficile lines RT027 and RT078 have recently become dominant all over the world. “It is true that these lines have been present in humans for years without causing major outbreaks; and in the 1980s, they were not epidemic or hypervirulent. "But after 2000, they started to dominate and cause major outbreaks," said the study's lead author, Dr. James Collins. The researchers therefore asked themselves why these lines could become such a health risk.

Bacteria can grow even with a low trehalose concentration

The scientists first analyzed the food sources of the two C. difficile lines and discovered that they can grow even with a low intake of the sugar substitute trehalose. The researchers wrote that the bacterial lines were sufficient to grow the trehalose about 1,000 times lower than the other bacteria of the same genus. However, this does not yet explain why the infections lead to more severe symptoms than before. According to the researchers, the increased toxicity of the bacteria is responsible here, because this also increases when the sugar substitute trehalose is added.

Increased mortality in the mouse model

The scientists checked their presumptions in the mouse model. They gave mice populated with a strain of the C. difficile RT027 line on a diet with or without trehalose. "What the mice ate affected the virulence of the infection and mortality was higher in the trehalose consuming group," reports Dr. Collins. The increased disease severity in the presence of trehalose cannot be explained by a higher number of bacteria, but is due to the increased toxicity at RT027.

Increasing number of outbreaks since trehalose was approved

According to the researchers, the knowledge gained is also reflected in the increasing number of Clostridium difficile infections for around 15 years. "In 2000, trehalose was approved as a food additive in the United States for a range of foods from sushi and vegetables to ice cream, and about three years later, reports of outbreaks with these lines began to increase," explains Prof. Britton.

Unexpected consequences of the sugar alternative

While other factors may also have contributed to the increased C. difficile outbreaks, "but we believe trehalose is an important trigger"; continued Britton. Above all, it is important to recognize that what was once thought to be a completely safe alternative to sugar can have unexpected consequences. In particular, the effect of trehalose in the diet in patients in hospitals with RT027 and RT078 outbreaks now needs to be investigated further. (fp)

Author and source information

Video: Management of Acute Diarrhea in Adults: A Global Perspective (August 2022).