{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T08:52:37Z","timestamp":1784796757206,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,10,28]],"date-time":"2016-10-28T00:00:00Z","timestamp":1477612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Obesity has been implicated in the acquisition of <jats:italic>Clostridium difficile<\/jats:italic> infections (<jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content>), however, no study has investigated whether there is a correlation between body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine whether obesity, as measured by <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> correlates with severe hospital\u2010onset or community\u2010onset <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients admitted with <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> at a tertiary\u2010care center from January 2013 to June 2015 were identified. The cohort was stratified by onset of disease using the National Healthcare Safety Network criteria, and by severity using the 2013 American College of Gastroenterology guidelines. Multivariate logistic regression was used to determine independent predictors of severe <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 196 met the inclusion criteria, of which 57.1% (112) met criteria for severe disease. Overall, <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> &gt;35 kg\/m<jats:sup>2<\/jats:sup> was 1.7\u2010fold more likely to be associated with severe <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> compared to a <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> 20\u201335 kg\/m<jats:sup>2<\/jats:sup> (<jats:italic>P<\/jats:italic> &lt; 0.005), and was an independent predictor of severe <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> (<jats:italic>P<\/jats:italic> = 0.038). In patients with community\u2010onset\u2010<jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> and hospital\u2010onset\u2010<jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content>, a <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> &gt;35 kg\/m<jats:sup>2<\/jats:sup> was associated with a 1.96\u2010fold and 1.48 greater rate of severe <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> compared to a <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> 20\u201335 kg\/m<jats:sup>2<\/jats:sup> (<jats:italic>P<\/jats:italic> = 0.004 and 0.048), and was an independent predictor of severe <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> in these cohorts (<jats:italic>P<\/jats:italic> = 0.039 and 0.027) respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study has identified an association between body mass index and <jats:italic>Clostridium difficile<\/jats:italic> infection severity. A <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>&gt;35 kg\/m<jats:sup>2<\/jats:sup> is an independent risk factor for severe community\u2010onset and hospital\u2010onset <jats:italic>Clostridium difficile<\/jats:italic> infections.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13832","type":"journal-article","created":{"date-parts":[[2016,10,28]],"date-time":"2016-10-28T07:23:24Z","timestamp":1477639404000},"page":"75-81","source":"Crossref","is-referenced-by-count":37,"title":["Body mass index greater than 35 is associated with severe <i>Clostridium difficile<\/i> infection"],"prefix":"10.1111","volume":"45","author":[{"given":"R.","family":"Mulki","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Einstein Medical Center Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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