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Cook the Italian sausage and red pepper flakes in a Dutch oven (or large pot with a lid) over medium-high heat until crumbly, browned, and no longer pink, 10 to 15 minutes. Drain, remove from pan, and set aside. The purpose of removing the sausage is so that you aren't boiling it in broth.
Add the bacon and cook until crispy. Remove from pan.
Add the onions and garlic the the same Dutch oven; cook until onions are soft and translucent, about 5 minutes.
Pour the chicken broth into the Dutch oven with the onion mixture; bring to a boil over high heat. Add the cauliflower, and boil until fork tender, about 15 minutes. Reduce the heat to medium and stir in the heavy cream and the cooked sausage; heat through. Mix the spinach and bacon into the soup a couple of minutes before serving. If you want a thicker soup, sprinkle the xanthan gum over the soup and quickly whisk in to combine and simmer until thickened. You can top with grated Parmesan if desired.