2582. The Association Between Dietary Fiber and Diet and Gut Colonization with Clostridium difficile

BACKGROUND: There is little research on the relationship between diet and Clostridium difficile infection. Animal studies have shown potential benefits of dietary fiber in modulating C. difficile infection. METHODS: In 2016–2017, we carried out a microbiota study among adults in the Survey of the Health of Wisconsin, a population-based health survey collecting data on a wide range of health determinants and outcomes. We administered the Dietary History Questionnaire and asked about risk factors for C. difficile and collected fecal samples for 16S rRNA sequencing of gut microbiota and cultured for C. difficile. Dietary components were standardized to 1,000 kcal energy intake. Logistic regression was used to examine diet factors associated with C. difficile colonization. The quasi-conditional association test (QCAT) was performed to identify taxa that were significantly associated with fiber intake. RESULTS: In our general population sample of adults [(N = 238; 58% female; mean (range) age = 54 (18–94)], the prevalence of gut colonization with C. difficile was 9.2% (18 toxigenic/3 non-toxigenic). After adjusting for age, sex, and antibiotic use, C. difficile colonization was associated with usual daily fiber consumption over the last year. ORs (95% CI) in the highest vs. lowest quartile were 0.18 (0.03, 0.89) for total fiber, 0.09 (0.01, 0.77) for soluble fiber, and 0.10 (0.1, 0.80) for insoluble fiber. Lower odds of C. difficile colonization were associated with greater consumption of dark green vegetables and less consumption of solid fats, total saturated fats, and added sugar, but not significantly. Omega 3 fatty acids and fruit consumption were either non-monotonically or not associated with C. difficile colonization. Higher levels of total dietary fiber intake were also associated with increased colonization by bacteria within the order Clostridiales, the families Coriobacteriaceae, Lactobacillaceae, and Veillonellacea, and the genera Bifidobacterium, and Lactobacillus. CONCLUSION: Higher average daily dietary fiber (total, soluble, and insoluble) appears to be associated with lower odds of gut colonization with C. difficile. Future research should examine the impact of dietary interventions on C. difficile colonization and infection. DISCLOSURES: All authors: No reported disclosures.