Obesity as a Risk Factor for Clostridium difficile Infection
Obesity as a Risk Factor for Clostridium difficile Infection
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DOI：
10.1093/cid/cit280
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发表时间：
2013-08-15
影响因子：
11.8
通讯作者：
Nseir, William
中科院分区：
文献类型：
--
作者：
Bishara, Jihad;Farah, Raymond;Nseir, William
背景。肥胖和艰难梭菌感染（CDI）都与肠道菌群中厚壁菌门/拟杆菌门比例增加有关。然而，肥胖和CDI之间的关系尚不清楚。我们的目的是评估住院患者肥胖与CDI之间的关系。我们进行了回顾性病例对照研究。纳入2011年1月至12月在2家医院2个内科连续住院的所有CDI患者。将CDI患者与同一时期同一科室的住院无腹泻患者进行比较，并根据年龄、性别、Charlson评分、住院时间和最近3个月内抗生素使用情况进行匹配。在6300名住院患者中，178名被诊断为CDI。CDI患病率为2.8%（178/6300）。30名患者被排除在研究之外。将148例CDI患者与148例住院对照进行比较。CDI组的平均体重指数（BMI）为33.6 (SD, 4.3)，对照组为28.9 (SD, 5.4) （P = .001）。匹配对的条件logistic回归多变量模型显示，腹部手术史（优势比[OR] = 2.865； 95%可信区间[CI]， 1.26-6.52）和高BMI值（OR = 1.196 / BMI量表每增加1单位；95% CI, 1.12-1.27）是唯一与cdi显著相关的变量。我们的研究结果表明，肥胖与CDI的风险有关。需要进一步的研究来揭示这种关联背后的确切机制。
Background. Obesity and Clostridium difficile infection (CDI) are both related to an increased Firmicutes/Bacteroidetes ratio in the intestinal microbiota. However, an association between obesity and CDI is unknown. We aimed to assess the association between obesity and CDI in hospitalized patients.Methods. We conducted a retrospective case-control study. From January to December 2011, all consecutive patients hospitalized with CDI, in 2 internal medical departments in 2 hospitals, were included. Patients with CDI were compared to hospitalized patients without diarrhea, during the same period and in the same departments, and matched by age, sex, Charlson score, length of hospitalization, and antibiotic use during the last 3 months.Results. Of the 6300 patients hospitalized, 178 were diagnosed with CDI. CDI prevalence was 2.8% (178/6300). Thirty patients were excluded from the study. The 148 cases with CDI were compared to 148 hospitalized controls. Mean body mass index (BMI) in the CDI group was 33.6 (SD, 4.3) versus 28.9 (SD, 5.4) in the control group (P = .001). The multivariable model of conditional logistic regression for matched pairs showed that a history of intra-abdominal surgery (odds ratio [OR] = 2.865; 95% confidence interval [CI], 1.26-6.52) and a high BMI value (OR = 1.196 per 1-unit increase in the BMI scale; 95% CI, 1.12-1.27) were the only variables found to be significantly associated with CDI.Conclusions. Our findings suggest that obesity is associated with the risk of CDI. Further studies are needed to reveal the exact mechanisms underlying this association.