Dietary fiber affects the onset of Clostridium difficile disease in hamsters

Abstract

Clostridium difficile is a leading cause of antibiotic-associated diarrhea in adults. The infection is usually initiated after antibiotics perturb the colonic microecology. The treatment of severe disease is a course of vancomycin or metronidazole, but non-antibiotic modalities to help in disease prevention and treatment are needed. Four fiber supplements used by humans were tested in ampicillin treated hamsters and their influence on Clostridium difficile disease was determined. After ampicillin dosing and inoculation of C. difficile, cellulose fiber and polycarbophil (both at p<0.03) lengthened time to disease onset, while psyllium (p<0.01) and soy fiber (p<0.02) decreased disease onset time. Several mechanisms of fiber action were examined, including changes in the number or activity of the gastrointestinal microflora, number of C. difficile toxin A receptors, and post-dose levels of antibiotic in the cecum. Although the tested fiber supplements did not prevent C. difficile disease, this study shows that the dietary fibers can modulate C. difficile disease onset times in this hamster model by different mechanisms.