Recurrent Multidrug-Resistant <i>Clostridium difficile</i> Infection Secondary to Ulcerative Colitis a Case Report
IBD consists of two diseases—CD and UC—that affect the digestive tract, with a greater affinity for the large bowel. In this case report, we focus on one of its most common complications. CDI is a pathology that is mostly secondary to UC. Another cause of this bacterial infection is established afte...
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MDPI AG
2023-08-01
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| Series: | Medical Sciences |
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| Online Access: | https://www.mdpi.com/2076-3271/11/3/52 |
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| author | Arturo P. Jaramillo Javier Castells Sabina Ibrahimli Steven Siegel |
| author_facet | Arturo P. Jaramillo Javier Castells Sabina Ibrahimli Steven Siegel |
| author_sort | Arturo P. Jaramillo |
| collection | DOAJ |
| description | IBD consists of two diseases—CD and UC—that affect the digestive tract, with a greater affinity for the large bowel. In this case report, we focus on one of its most common complications. CDI is a pathology that is mostly secondary to UC. Another cause of this bacterial infection is established after the use of antibiotics, most commonly at the hospital level. Around 20 percent of CDI persists because of a chronic dysbiosis of the microbiota and low levels of antibodies against CD toxins. In this case report, we demonstrated mdCDI in a young woman after treatment with multiple drug therapies as well as with semi-invasive procedures as follows: antibiotics (vancomycin, fidaxomicin), anti-inflammatory agents (mesalamine, sulfasalazine), corticosteroids (budesonide, prednisone), integrin receptor antagonists (vedolizumab), several semi-invasive procedures such as fecal transplant microbiota (FMT), aminosalicylates (5-ASA), treatment with tumor necrosis factor (TNF) blockers (adalimumab, golimumab), and immunomodulators (upadcitinib, tofacitinib). This leads us to establish how rCDI and its resistance to different treatments make this a challenge for the health system, both for hospitals and for outpatients, as well as how time-consuming each treatment is from the first intake of the drug until its total efficacy or until patients reach a dose-response and time-response to the disease. Accordingly, this case report and other similar cases reflect the need for randomized control trials or meta-analyses to establish therapeutic guidelines for cases of mdCDI in the near future. |
| first_indexed | 2024-03-10T22:28:53Z |
| format | Article |
| id | doaj.art-441e6441085440a6932ff91519b03585 |
| institution | Directory Open Access Journal |
| issn | 2076-3271 |
| language | English |
| last_indexed | 2024-03-10T22:28:53Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medical Sciences |
| spelling | doaj.art-441e6441085440a6932ff91519b035852023-11-19T11:53:46ZengMDPI AGMedical Sciences2076-32712023-08-011135210.3390/medsci11030052Recurrent Multidrug-Resistant <i>Clostridium difficile</i> Infection Secondary to Ulcerative Colitis a Case ReportArturo P. Jaramillo0Javier Castells1Sabina Ibrahimli2Steven Siegel3General Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, CA 94534, USAInternal Medicine, Universidad Católica de Santiago de Guayaquil, Guayaquil 090615, EcuadorCardiology, First Moscow State Medical University, 119992 Moscow, RussiaDepartment of Internal Medicine, Coney Island Hospital, 2601 Ocean Parkway, Brooklyn, NY 11235, USAIBD consists of two diseases—CD and UC—that affect the digestive tract, with a greater affinity for the large bowel. In this case report, we focus on one of its most common complications. CDI is a pathology that is mostly secondary to UC. Another cause of this bacterial infection is established after the use of antibiotics, most commonly at the hospital level. Around 20 percent of CDI persists because of a chronic dysbiosis of the microbiota and low levels of antibodies against CD toxins. In this case report, we demonstrated mdCDI in a young woman after treatment with multiple drug therapies as well as with semi-invasive procedures as follows: antibiotics (vancomycin, fidaxomicin), anti-inflammatory agents (mesalamine, sulfasalazine), corticosteroids (budesonide, prednisone), integrin receptor antagonists (vedolizumab), several semi-invasive procedures such as fecal transplant microbiota (FMT), aminosalicylates (5-ASA), treatment with tumor necrosis factor (TNF) blockers (adalimumab, golimumab), and immunomodulators (upadcitinib, tofacitinib). This leads us to establish how rCDI and its resistance to different treatments make this a challenge for the health system, both for hospitals and for outpatients, as well as how time-consuming each treatment is from the first intake of the drug until its total efficacy or until patients reach a dose-response and time-response to the disease. Accordingly, this case report and other similar cases reflect the need for randomized control trials or meta-analyses to establish therapeutic guidelines for cases of mdCDI in the near future.https://www.mdpi.com/2076-3271/11/3/52inflammatory bowel diseaseCrohn’s diseaseulcerative colitis<i>Clostridium difficile</i> infection<i>Clostridium difficile</i> infection therapy |
| spellingShingle | Arturo P. Jaramillo Javier Castells Sabina Ibrahimli Steven Siegel Recurrent Multidrug-Resistant <i>Clostridium difficile</i> Infection Secondary to Ulcerative Colitis a Case Report Medical Sciences inflammatory bowel disease Crohn’s disease ulcerative colitis <i>Clostridium difficile</i> infection <i>Clostridium difficile</i> infection therapy |
| title | Recurrent Multidrug-Resistant <i>Clostridium difficile</i> Infection Secondary to Ulcerative Colitis a Case Report |
| title_full | Recurrent Multidrug-Resistant <i>Clostridium difficile</i> Infection Secondary to Ulcerative Colitis a Case Report |
| title_fullStr | Recurrent Multidrug-Resistant <i>Clostridium difficile</i> Infection Secondary to Ulcerative Colitis a Case Report |
| title_full_unstemmed | Recurrent Multidrug-Resistant <i>Clostridium difficile</i> Infection Secondary to Ulcerative Colitis a Case Report |
| title_short | Recurrent Multidrug-Resistant <i>Clostridium difficile</i> Infection Secondary to Ulcerative Colitis a Case Report |
| title_sort | recurrent multidrug resistant i clostridium difficile i infection secondary to ulcerative colitis a case report |
| topic | inflammatory bowel disease Crohn’s disease ulcerative colitis <i>Clostridium difficile</i> infection <i>Clostridium difficile</i> infection therapy |
| url | https://www.mdpi.com/2076-3271/11/3/52 |
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