TOPLINE

Metabolic syndrome (MetS) raises the risk for Clostridioides difficile infection (CDI) by more than 90%, while obesity and type 2 diabetes (T2D) each raise the odds by more than 10%. Patients with T2D face the greatest risk for severe complications, including sepsis, ICU admission, recurrent infection, and mortality.

METHODOLOGY

• Researchers conducted a retrospective cohort study using electronic health record data from 102 healthcare organizations in the United States.
• A total of 3 separate matched cohorts were analyzed: patients with MetS (n = 184,051), obesity (n = 1,140,942), or T2D (n = 616,801) were each compared with matched control individuals without these conditions.
• MetS was defined by the presence of central obesity, hypertriglyceridemia, low HDL cholesterol, hypertension, and T2D.
• Primary outcome was a diagnosis of CDI; secondary outcomes included sepsis, leukocytosis, neutrophilia, hypoalbuminemia, ICU admission, recurrent CDI, and all-cause mortality.

TAKEAWAY

• The odds of CDI diagnosis were higher among patients diagnosed with MetS (odds ratio [OR], 1.94), obesity (OR, 1.14), and T2D (OR, 1.11; P < .0001 for all) than among those without these diagnoses.
• Patients with CDI who also had MetS or obesity had increased odds of severe sepsis, leukocytosis, and neutrophilia, but lower risk for hypoalbuminemia, recurrent CDI, and all-cause mortality than those without MetS or obesity.
• In contrast, patients with CDI and T2D demonstrated greater odds of developing all CDI outcomes evaluated than those without T2D.
• Class 3 obesity was associated with the highest risk for severe CDI outcomes compared with class 2 or class 1 obesity.

IN PRACTICE

"From this study, we will be able to consider the metabolic health of patients when assessing prognosis and adjusting management for patients with CDI," wrote the authors of the study.

SOURCE

The study was led by Stella O. Oyewole, Department of Pathobiology and Molecular Medicine, University of Cincinnati College of Medicine, Cincinnati. It was published online on July 22 in Open Forum Infectious Diseases.

LIMITATIONS

The study relied on diagnostic codes, which may be subject to coding errors or incomplete documentation. Generalizability may be limited by the patient populations represented in the electronic health record database. The study did not account for all potential confounding variables that could influence CDI risk and outcomes.

DISCLOSURES

The study was supported by grants from the National Institute of Allergy and Infectious Diseases and US Department of Veterans Affairs MERIT Review. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.