Obesity as a Risk Factor for Clostridium difficile Infection

Bishara, Jihad; Farah, Raymond; Mograbi, Julnar; Khalaila, Wissam; Abu-Elheja, O.; Mahamid, Mahmud; Nseir, William

doi:10.1093/cid/cit280

Cited by 93 publications

(54 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Comorbidities favoring this infection include: immunosuppression, diabetes, chronic renal failure, and recurring urinary tract infection. Chronic exposure to proton pump inhibitors (PPIs) is also a risk factor 2,3,4 . CDI is associated with a high risk of morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Emergence of community-acquired Clostridium difficile infection: the experience of a French hospital and review of the literature

Ogielska

Lanotte

Brun

et al. 2015

International Journal of Infectious Diseases

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Emergence of community-acquired Clostridium difficile infection: the experience of a French hospital and review of the literature

Ogielska

Lanotte

Brun

et al. 2015

International Journal of Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…Studies of this topic have been carried out in different countries [11][12][13]. However, few reports have focused on CDI in China.…”

Section: Introductionmentioning

confidence: 99%

Clinical characterization and risk factors of Clostridium difficile infection in elderly patients in a Chinese hospital

Zhang

Dong

Jiang

et al. 2015

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Clostridium difficile is a common cause of nosocomial diarrhea, especially in elderly patients. This study aimed to analyze the clinical features and assess the risk factors associated with Clostridium difficile infection (CDI) in elderly hospitalized patients. Methodology: A retrospective case-control study was conducted among elderly hospitalized patients (> 60 years of age) in a Chinese tertiary hospital between 2010 and 2013. Fifty-two CDI patients and 150 randomly selected non-CDI patients were included in the study. Clinical features of CDI and non-CDI patients were compared by appropriate statistical tests. Logistic regression analyses were performed on a series of factors to determine the risk factors for CDI among the elderly hospitalized patients. Results: The elderly CDI patients showed higher leukocyte counts, lower serum albumin levels, longer duration of hospital stay, and higher mortality compared to the non-CDI patients. The proportion of patients admitted to the intensive care unit or exposed to gastric acid suppressants was also significantly different (p < 0.05) between the two groups. Multivariate analysis indicated that serum creatinine (OR 1.004; 95% CI 1.001-1.008), surgical intervention (OR 6.132; 95% CI 2.594-14.493), the number of comorbidities (OR 2.573; 95% CI 1.353-4.892), gastrointestinal disease (OR 4.670; 95% CI 2.002-10.895), and antibiotic use (OR 6.718; 95% CI 2.846-15.859) were independently associated with CDI. Conclusions: This study revealed several risk factors for CDI among elderly hospitalized patients. These findings will increase the knowledge concerning this disease and provide information regarding the control and prevention of CDI in the elderly.

show abstract

“…Factors shown to repeatedly correlate with RCDI were increasing age (≥ 65 years old), antibiotic therapy, and concomitant use of acid-suppressing medications (proton-pump inhibitors most frequently studied) (5)(6)(7)(12)(13)(14)(15)(16). While these factors were the most commonly cited, there are many other factors individually studied and found to be independently associated with CDI/RCDI including obesity, intraabdominal or gastrointestinal surgery, tube feedings or nasogastric tubes, inflammatory bowel disease (IBD), and immunocompromising disease states or medications (1,4,(17)(18)(19)(20)(21). The purpose of this study was to identify factors associated with RCDI and develop an evaluation tool to stratify the risk of developing recurrent infection.…”

Section: Clostridium Difficile Infection (Cdi) Occurs Whenmentioning

confidence: 99%

Identification of Factors Impacting Recurrent Clostridium difficile Infection and Development of a Risk Evaluation Tool

et al. 2016

View full text Add to dashboard Cite

-Purpose. Recurrent Clostridium difficile infection (RCDI) is a growing concern, yet limited data exists to clarify which patients are at highest risk. Identification of these patients may better inform decisions of those who may benefit from prophylactic intervention. The purpose of this study was to determine which factors are associated with the recurrence of Clostridium difficile infection (CDI) and to develop a risk stratification tool. Methods. Patients readmitted within 10 weeks of positive C. difficile polymerase chain reaction (PCR) with symptoms were included in this retrospective case control study. The primary outcome was analyzed via univariate regression analyses of the independent factors including age, gender, number of CDI episodes, administration of acid blocking agents, antibiotics or chemotherapy, Charlson Comorbidity Index, gastrointestinal conditions, and exposure to healthcare facilities. Results. Recurrent CDI was identified in 44 of 220 included patients. In the univariate analysis, factors associated with development of RCDI included antibiotic exposure (OR 2.51, 95% CI 1.14-5.54; p 0.02) and inflammatory bowel disease (OR 5.77, 95% CI 1.24-26.79; p 0.03). An evaluation tool was created from a well-fit model. Additional factors included in the tool were chosen based on evaluation of findings from existing literature. Conclusions. Antibiotic therapy and inflammatory bowel disease were found to be associated with RCDI. Although a statistically significant association with RCDI was not found for other factors, this is likely related to small sample size. The creation of an evaluation tool using specific patient factors can help determine the risk of RCDI, while future studies may validate this tool.

show abstract

Obesity as a Risk Factor for Clostridium difficile Infection

Abstract: Our findings suggest that obesity is associated with the risk of CDI. Further studies are needed to reveal the exact mechanisms underlying this association.

Cited by 93 publications

References 26 publications

Emergence of community-acquired Clostridium difficile infection: the experience of a French hospital and review of the literature

Emergence of community-acquired Clostridium difficile infection: the experience of a French hospital and review of the literature

Clinical characterization and risk factors of Clostridium difficile infection in elderly patients in a Chinese hospital

Identification of Factors Impacting Recurrent Clostridium difficile Infection and Development of a Risk Evaluation Tool

Contact Info

Product

Resources

About