Dietary trehalose enhances virulence of epidemic Clostridium difficile

Ars Technica's writeup: https://arstechnica.com/science/2018/01/the-curious-case-of-...

> By 2011, the Centers for Disease Control and Prevention estimated that C. diff infected nearly half a million people in the US that year, killing approximately 29,000.

Nature's editorial: https://www.nature.com/articles/d41586-017-08775-4

> First, they showed that deleting treA in RT027 and thereby preventing trehalose metabolism markedly reduced the virulence of this strain in mice. Second, adding trehalose to the diet of mice infected with RT027 increased the animals’ risk of death.

> RT027 was first isolated in 1985, from a person infected with C. difficile. But this ribotype was not associated with hospital outbreaks, increased death rates or epidemics until the early 2000s... Why did these ribotypes suddenly emerge at epidemic levels only 15 years ago?

> Collins and colleagues propose a surprising answer. Before 1995, high production costs made trehalose untenable as a food additive. But manufacturing innovations reduced the cost of trehalose production more than 100-fold, and the US Food and Drug Administration and European agencies approved the sugar as a safe food additive in 2000 and 2001, respectively. Trehalose is now added to a variety of food products, including pasta, ice cream and minced beef. The authors provide a timeline (see Fig. 6 of the paper) to illustrate how supplementing the food supply with trehalose preceded the C. difficile outbreaks caused by RT027 and RT078. They therefore suggest that the addition of trehalose to the food supply might have increased the sugar in the human bowel to levels high enough to enable growth of these ribotypes.

> The study’s findings raise several avenues for future research... whether trehalose in the human colon, where disease occurs, reaches high enough levels to affect RT027 and RT078 virulence is also unknown.

Causality hasn't been proven yet, but this is tough to ignore.

"[Trehalose] is commonly used in prepared frozen foods, like ice cream, because it lowers the freezing point of foods."

More:

https://en.wikipedia.org/wiki/Trehalose#Nutritional_and_diet...

Has it been shown, or is there some reason to expect, that this is unique among disaccharides? Or would this result tend to predict the same relationship with e.g. sucrose, maltose, or lactose?