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Obesity may increase risk for C. difficile
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Researchers from Israel have found that obesity may be associated with increased risk for Clostridium difficile infection.
“Recent evidence, primarily from investigations of animal models, suggests that gut microbiota affects nutrient acquisition and energy regulation,” the researchers wrote in Clinical Infectious Diseases. “Its composition has also been shown to differ in lean vs. obese animals and humans. Initial findings have linked obesity with the decreased relative proportion of Bacteroidetes to Firmicutes. Thus, we hypothesized that obese patients might be more susceptible to C. difficile infection than lean subjects.”
The retrospective case-control study included all consecutive patients hospitalized with C. difficile at two hospitals from January to December 2011. The patients were matched to other hospitalized patients without diarrhea, according to age, gender, Charlson score, length of hospitalization and antibiotic use in the past 3 months.
Of 6,300 hospitalized patients, 178 were diagnosed with C. difficile, for a prevalence of 2.8%. Thirty patients were excluded, so 148 patients were matched with controls. Among patients with C. difficile, the mean BMI was 33.6 compared with 28.9 for the controls (P=.001). On a multivariable analysis, a history of intra-abdominal surgery (OR=2.865; 95% CI, 1.26-6.52) and a high BMI (OR=1.196 per 1-unit increase; 95% CI, 1.12-1.27) were significantly associated with C. difficile.
“The cross-sectional nature of our study does not allow us to conclude regarding the causal relationship between C. difficile and obesity,” the researchers wrote. “For that to be shown, a longitudinal study using panel data should be carried out. Further restriction and prudent use of antibiotics in obese patients is recommended.”
Disclosure: The researchers report no relevant financial disclosures.
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