29 Oct C.diff and Obesity
MedicalResearch.com Interview with:
Nahid Bhadelia, MD, MALD
Associate Hospital Epidemiologist, Section of Infectious Diseases
Director, Infection Control
National Emerging Infectious Diseases Laboratory (NEIDL)
Boston Medical Center, Boston, MA
Summary of Findings:
Clostridium difficile infections (CDI) are a growing problem related to healthcare exposure and antibiotic use. Over the last decade, these infections have been noted to present in patients from the community without traditional risk factors. We examined 132 patients over a six month period presenting to our medical center with CDI to explore the association between obesity and CDI. We hypothesized that in a group without exposure to health care facilities, the statistical significance of other risk factors such as obesity and IBD may be increased. Our results showed that patients with community onset CDI without known health exposure were 4 times more likely to be obese than their counterparts (OR, 4.06 95% CI 1.15–14.36) with known healthcare exposure. Furthermore, this former group was also statistically more obese than the general population of Massachusetts (34% vs 23%, OR 1.7, 95% CI 1.02–2.99).
We did not note a similar difference between community onset patients without healthcare exposure and patients who developed CDI in the hospital. This may be due to limitations of sample size or because obesity maybe a confounder in hospitalized patients and a marker for other conditions requiring admission.
Obesity has not previously been considered a risk factor for CDI but given the similarities in the derangement of gut microbiome in obese patients and that of patients with inflammatory bowel disease and recurrent antibiotic use, there is biological plausibility for this finding. Further prospective and translational research is required to elucidate the pathogenesis behind this observation. These findings may contribute to improved clinical surveillance of those at highest risk of disease.