Stomach Bug Possibly Tied to Obesity

Obesity higher in patients with Clostridium difficile infections than general public in new study

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Obesity raises the risk for issues like cardiovascular disease and diabetes, but could obesity also increase the risk for an infection of the gut? Researchers are exploring the possibility.

A new study looked at a potential connection between infections with the germ Clostridium difficile and obesity.

In this small study, the researchers found that patients who developed the infection were more likely to be obese than the general public.

"Maintain a healthy weight."

Clostridium difficile is spread through feces-contaminated surfaces and often causes infection in people in healthcare settings. Symptoms of infection with C. difficile include watery diarrhea, fever and nausea, and the Centers for Disease Control and Prevention (CDC) reports that the infection causes around 14,000 deaths every year in the US. 

According to the study's authors, who were led by Jason Leung, MD, of the University of Michigan Hospital in Ann Arbor, previous studies have identified inflammatory bowel disease (IBD), a variety of conditions involving inflammation of the intestines, as a risk factor for C. difficile infections.

It is thought that the IBD-C. difficile connection might exist due to disruptions to the microbiome, or environmental system of microbes, in the intestines. Dr. Leung and team wanted to explore if similar disruptions to the intestinal microbiome caused by obesity might also be associated with C. difficile infections.

To do so, the researchers looked at the medical records at Boston Medical Center over a six-month period. The researchers measured obesity by looking at participants' body mass indexes (BMI), a proportion of weight and height. A BMI over 30 is typically considered obese. 

Dr. Leung and team identified 132 patients with confirmed C. difficile infections during the six months of the study. Of these patients, 91 developed the infection somewhere in the community at large ("community onset") and 41 developed the infection while in a healthcare facility.

A total of 32 of the community onset patients developed the infection after being exposed to a healthcare facility at some point in the month before becoming ill.

The researchers found that patients with C. difficile infections tended to have higher BMIs than the general population. Of the community onset group, 34 percent were obese, and 32 percent of the heathcare facility onset group were obese, compared to the state average of 23 percent.

The researchers also found that 17 percent of the community onset group had IBD, compared to 2 percent of those who developed C. difficile infections in a healthcare facility. 

The sample size for this study was fairly small, and more research is needed to confirm a possible association between C. difficile infections and obesity.

"...[I]t is critical to establish whether obesity is a risk factor for high rates of C. difficile colonization, as is IBD; if that risk factor is established, prospective observations would improve understanding of whether obesity plays a role in the acquisition of CDI, or alters severity of disease and risk for recurrence," Dr. Leung and team concluded. 

The study will be published in the November issue of CDC's Emerging Infectious Diseases journal. No conflicts of interest were reported.

Review Date: 
October 24, 2013
Last Updated:
October 26, 2013