<b>A sucrose-rich diet promotes</b> <i> <b>Clostridioides difficile</b> </i> <b>carriage without prior antibiotics and significantly exacerbates both acute disease and long-term colonization</b>
<i>Clostridioides difficile</i> is a major cause of healthcare-associated diarrhea, with rising rates of community-acquired infections and asymptomatic carriage. While antibiotic exposure is a well-established risk factor, the role of diet in modulating susceptibility remains underexplored. Here, we demonstrate that a high-sucrose diet profoundly alters host susceptibility to <i>C. difficile</i> in a murine model. Mice consuming sucrose-rich chow exhibited exacerbated disease severity, characterized by increased weight loss, elevated clinical scores, heightened toxin burden, and persistent intestinal inflammation. Mice fed a high-sucrose diet failed to clear <i>C. difficile</i> and remained colonized long-term remaining susceptible to recurrent disease. Critically, high-sucrose-diet mice were susceptible to asymptomatic <i>C. difficile</i> carriage without prior antibiotic treatment, which progressed to overt CDI upon antibiotic exposure. Microbiome and metabolome profiling revealed that consumption of a sucrose-rich diet reshaped the gut microbiota, marked by blooms of <i>Enterococcus</i> and <i>Akkermansia</i>, a reduction in beneficial taxa, and remodeled the metabolome to favor <i>C. difficile</i> germination and growth. These findings establish dietary sucrose as a modulator of colonization resistance and identify a novel model of diet-induced asymptomatic carriage, with implications for the rising burden of community-associated <i>C. difficile</i> infection.
Authors
- Michelle Chua
- Daniel P. Erickson (ORCID: https://orcid.org/0000-0001-5143-9193)
- Katelyn R. Sheneman (ORCID: https://orcid.org/0000-0001-5374-5055)
- Lorraine D. Hernandez
- James Collins (ORCID: https://orcid.org/0000-0003-2479-5189)
Institutions
- University of Louisville (US)
- Predict (France) (FR)
Publication Details
- Journal
- Gut Microbes
- Published
- 2025-10-14
- DOI
- https://doi.org/10.1080/19490976.2025.2566302
- Citations
- 1
- Primary Topic
- Clostridium difficile and Clostridium perfringens research
- Type
- article
- Field-Weighted Citation Impact
- 1.40