title: Is obesity a risk factor for Clostridium difficile infection?
abstract: BACKGROUND
  The epidemiology of Clostridium difficile infection (CDI) has become an important area of investigation, especially in light of the global increase in both hospital-acquired (HA) and community-acquired (CA) CDI. Recently, obesity was found to be associated with CDI and was suggested to represent an independent risk factor for it.
  
  
  OBJECTIVE
  We undertook a case-control study to examine obesity as an exposure for both HA and CA cases in adults (age ≥ 18 years) admitted to a tertiary, university-affiliated, acute care medical facility in the northeastern United States.
  
  
  METHODS
  During the period January 2012-July 2013, we examined cross-sectional BMI data on 189 cases of CDI and 189 contemporaneous age and gender-matched controls.
  
  
  RESULTS
  We were unable to detect a statistically significant difference between the two groups; in fact, the BMI values for both groups were substantially equivalent (cases: median=26.5 kg/m, IQR: 22.1-32.5; controls: median=26.0, IQR: 22.7-31.0; p=0.696). Odds ratios (and 95% confidence intervals), evaluated at BMI of 25, 30 and 35 kg/m(2), did not demonstrate statistical significance.
  
  
  CONCLUSIONS
  These data suggest that obesity, as described by BMI, may not be a risk factor for CDI in all populations.
authors: Department of Medical Education, St. Joseph's Regional Medical Center, Paterson, NJ, USA.
authors: Emma
authors: E
authors: Punni
authors: Department of Pediatrics, St. Joseph's Regional Medical Center, Paterson, NJ, USA.
authors: Jaime L
authors: JL
authors: Pula
authors: Division of Gastroenterology, St. Joseph's Regional Medical Center, Paterson, NJ, USA.
authors: Fady
authors: F
authors: Asslo
authors: Department of Medical Education, St. Joseph's Regional Medical Center, Paterson, NJ, USA; Division of Gastroenterology, St. Joseph's Regional Medical Center, Paterson, NJ, USA.
authors: Walid
authors: W
authors: Baddoura
authors: Department of Medical Education, St. Joseph's Regional Medical Center, Paterson, NJ, USA; Department of Internal Medicine, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ, USA. Electronic address: Vincent.debari@shu.edu.
authors: Vincent A
authors: VA
authors: DeBari
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D017714:Community-Acquired Infections / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D003428:Cross Infection / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009511:New England / Q000453:epidemiology; D009765:Obesity / Q000150:complications* / Q000276:immunology / Q000382:microbiology; D011159:Population Surveillance; D018570:Risk Assessment; D012307:Risk Factors
keywords: Body mass index; Clostridium difficile infection; Epidemiology; Obesity; Risk factors