Rezistenţa la tratament în infecţia cu Clostridium difficile.

Introduction: Clostridium difficile infection is one of the most severe intestinal disturbances that usually occurs to hospitalized patients or patients who have undergone long antibiotic treatment. It commonly manifests as a diarrheal syndrome and has a medical, surgical and epidemiological emergency character. Case presentation: We report the case of a 60-yearold patient known with small bowel resection and secondary chronic diarrhea who was transferred from the Gastroenterology Department with the diagnosis of Clostridium difficile colitis. He received there maximal treatment with vancomycin and metronidazole. In the Infectious Diseases Department, fecal microbiota transplant was performed with the persistence of an accelerated intestinal transit. Subsequently, rescue treatment with tigecycline accompanied by administration of pancreatic enzymes resulted in the resolution of acute diarrhea syndrome. Conclusions: In treatment resistant Clostridium difficile infection, fecal microbiota transplant is a therapeutic solution and could be used from the first episode of colitis. In severe cases, systemic administration of tigecycline is legitimate. Treatment of infection should not be approached isolatedly, but in conjunction with treatment of patient's comorbidities. [ABSTRACT FROM AUTHOR]