Dietary fiber affects the onset of Clostridium difficile disease in hamsters

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 vanco mycin or metronidazole, but non-antibiotic modalities to help in disease pr evention and treatment are needed. Four fiber supplements used by humans we re 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) lengthe ned time to disease onset, while psyllium (p<0.01) and soy fiber (p<0.02) d ecreased disease onset time. Several mechanisms of fiber action were examin ed, including changes in the number or activity of the gastrointestinal mic roflora, number of C. difficile toxin A receptors, and post-dose levels of antibiotic in the cecum. Although the tested fiber supplements did not prev ent C. difficile disease, this study shows that the dietary fibers can modu late C, difficile disease onset times in this hamster model by different me chanisms. (C) 2000 Elsevier Science Inc.