Obesity and the risk and outcome of infection

Abstract

The interactions between obesity and infectious diseases have recently received increasing recognition as emerging data have indicated an association between obesity and poor outcome in pandemic H1N1 influenza infection. Obesity is an established risk factor for surgical-site infections, nosocomial infections, periodontitis and skin infections. Several studies indicate that acute pancreatitis is more severe in the obese. Data are controversial and limited as regards the association between obesity and the risk and outcome of community-acquired infections such as pneumonia, bacteremia and sepsis and obesity and the course of HIV infection. As the cause-effect relationship between obesity and infection remains obscure in many infectious diseases, further studies are warranted. The consequences of obesity may have substantial effects on the global burden of infectious diseases.

Perioperative management of the severely obese patient: a selective pathophysiological review

“…129 Patients with obesity are more likely to develop bloodstream infection, skin and softtissue infections, wound infections, wound dehiscence, urinary infections, and possibly pulmonary infections. 130 This may relate to the combined effect of obesity-related immune dysfunction with altered tissue perfusion and perhaps inadequate antimicrobial dosing, but the effects of comorbidities, such as diabetes, should not be forgotten. Obesity and the accompanying chronic inflammatory state alter the number and function of dendritic epidermal T cells responsible for skin barrier functions and wound re-epithelialization, which results in less efficient wound healing.…”

Pulmonary function in patients with pandemic H1N1

“…Obesity can in luence the measure of lung volumes because it interferes in the diaphragmatic movement such as the chest wall, leading to the reduction of the maximum voluntary ventilation (13,23,24). The predisposition to infections which obese individuals posses has been described in research, however regarding the respiratory system, precise data has not yet been disclosed, making more research necessary (25).…”

Risk factors for cytomegalovirus reactivation after liver transplantation: Can pre‐transplant cytomegalovirus antibody titers predict outcome?

“…21,22 The secretion of cytokines from adipose tissue in obese patients may dysregulate the immune system, although the true mechanism remains unclear. 23,24 A prolonged cold ischemia time has been shown to increase the risk of ischemic cholangiopathy and subsequent allograft rejection. 22 This event may predispose these patients to more aggressive immunosuppression and thus lead to an increased risk of CMV infection.…”

“…The median age was 57 years (IQR, 47-62 years), and the sex distribution was almost equal. The median MELD score was 25 (IQR, [18][19][20][21][22][23][24][25][26][27][28][29]. The majority of patients were Caucasian (85%).…”