Obesity and nosocomial infections

Area of Science:

• Infectious Diseases
• Public Health
• Clinical Medicine

Background:

• Healthcare-associated infections (HCAIs) pose a significant challenge in modern healthcare settings.
• Intrinsic patient factors, such as obesity, are increasingly recognized as contributors to HCAI risk.

Purpose of the Study:

• To systematically review the existing literature on the association between obesity and the risk and outcomes of HCAIs.
• To investigate the impact of obesity on antimicrobial dosing in the context of HCAIs.

Main Methods:

• A comprehensive literature search was conducted using PubMed, focusing on studies linking obesity with nosocomial infections and antimicrobial dosing.
• Key search terms included 'obesity,' 'infection,' 'nosocomial infection,' 'surgical site infection,' 'critical care unit,' 'bacteremia,' 'urinary tract infection,' and 'health care associated infection.'

Main Results:

• Multiple studies indicate a clear association between obesity and an increased risk of HCAIs, particularly in cardiac, vascular, orthopedic, and gastrointestinal surgeries.
• Obesity is frequently linked to the underdosing of antimicrobials for both prophylaxis and treatment of HCAIs, affecting drug pharmacokinetics.
• Systematic recording of Body Mass Index (BMI) data is inconsistent, preventing the determination of precise BMI cut-offs for elevated infection risk.

Conclusions:

• Obesity is a significant risk factor for nosocomial infections and is often associated with suboptimal antimicrobial dosing.
• Future hospital hygiene and infection prevention efforts must consider the growing challenge of obesity epidemics.