Researchers from Boston Medical Center (BMC) and Boston University School of Medicine (BUSM) found that obesity may promote susceptibility to clostridium difficile infection (CDI). The study published was a retrospective analysis of the infection control databases, microbiology results, and medical records of all patients who had laboratory proven CDI at BMC.
Of 132 patients, 43% had community onset, 30% had health care facility onset, and 23% had community onset after exposure to a health care facility. Patients with community onset had higher body mass indices (BMI) than the general population and those who had prior known exposure to a healthcare facility, had higher rates of Inflammatory bowel disease (IBD), which has been identified as an independent risk factor for C. difficile colonization and disease. Obesity may be associated with CDI, independent of antibacterial drug or health care exposures.
Changes in fecal microbiomes have been demonstrated in recurrent cases of CDI associated with antibacterial drug use (Young et al). This defect is also noted in obese patients with IBD. The similarities in alterations of normal microbial symbiosis in both IBD and obesity may explain why obese patients may be at risk for acquiring CO CDI.