Dental News - Study shows trehalose responsible for C. difficile outbreaks

Study shows trehalose responsible for C. difficile outbreaks

Trehalose, a disaccharide often used as a food additive, has been found to be responsible for the increased frequency of hospital-acquired C. difficile infections in developed countries. (Image: molekuul_be/Shutterstock)

Dental Tribune International

Mon. 29. January 2018

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HOUSTON, Texas, USA: In the twenty-first century, outbreaks of Clostridium difficile infections have occurred with an increased frequency in both Europe and North America, causing this bacterial infection to become the most common hospital-acquired infection in developed countries. Curiously, however, little is known about what has initiated this rising epidemic. A study recently published in the Nature journal has helped to shed light on the source of the problem: trehalose, a disaccharide often used as a food additive and in certain dental prophylactic polishing powders.

Before 2000, trehalose was rarely used, since its manufacture was prohibitively expensive. The introduction of a novel enzymatic method reduced its production costs more than 100-fold, making the substance commercially viable. Approved for food use in the US in 2000 and Europe in 2001, trehalose was positioned as a healthy alternative to sugar and is still added to foods as diverse as ice cream, instant noodles, rice and beef mince. Given its slightly sweet flavour, trehalose is now used as an abrasive agent in periodontal powders produced for sub- and supragingival cleaning.

Coinciding with the widespread adoption of trehalose, two distinct C. difficile lineages—RT027 and RT078—were involved in major outbreaks of this bacterial infection throughout the world. By analysing the genomes of RT027 and RT078, a research team led by Prof. Robert Britton of the Baylor College of Medicine in Houston in the US has found that each strain is able to grow in unusually low levels of trehalose. They therefore suggested that this sugar’s presence may well be responsible for recent C. difficile epidemics.

C. difficile infections are often indicated by intense nausea, diarrhoea and abdominal pain, and if they are left untreated, can prove to be deadly. According to the European Centre for Disease Prevention and Control, the bacterium is responsible for 48 per cent of all health care-associated gastrointestinal infections in European hospitals. Its American counterpart, in a 2015 study published in the New England Journal of Medicine, placed the cost of C. difficile infections in the US at US$4.8 billion per year.

The study, titled “Dietary trehalose enhances virulence of epidemic Clostridium difficile”, was published online on 3 January 2018 in the Nature journal.