{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:24:29Z","timestamp":1760149469451,"version":"build-2065373602"},"reference-count":11,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T00:00:00Z","timestamp":1692144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>IBD consists of two diseases\u2014CD and UC\u2014that 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.<\/jats:p>","DOI":"10.3390\/medsci11030052","type":"journal-article","created":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T10:08:09Z","timestamp":1692180489000},"page":"52","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Recurrent Multidrug-Resistant Clostridium difficile Infection Secondary to Ulcerative Colitis a Case Report"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8763-4564","authenticated-orcid":false,"given":"Arturo P.","family":"Jaramillo","sequence":"first","affiliation":[{"name":"General Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, CA 94534, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Castells","sequence":"additional","affiliation":[{"name":"Internal Medicine, Universidad Cat\u00f3lica de Santiago de Guayaquil, Guayaquil 090615, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabina","family":"Ibrahimli","sequence":"additional","affiliation":[{"name":"Cardiology, First Moscow State Medical University, 119992 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Siegel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Coney Island Hospital, 2601 Ocean Parkway, Brooklyn, NY 11235, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"11525","DOI":"10.3748\/wjg.v20.i33.11525","article-title":"Clinical characteristics and treatment of inflammatory bowel disease: A comparison of Eastern and Western perspectives","volume":"20","author":"Park","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1038\/ajg.2013.4","article-title":"Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections","volume":"108","author":"Surawicz","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1086\/651706","article-title":"Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA)","volume":"31","author":"Cohen","year":"2010","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.cmi.2021.09.038","article-title":"European Society of Clinical Microbiology and Infectious Diseases: 2021 Update on the Treatment Guidance Document for Clostridioides Difficile Infection in Adults","volume":"27","author":"Reigadas","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/1469-0691.12418","article-title":"European Society of Clinical Microbiology and Infectious Diseases: Update of the treatment guidance document for Clostridium difficile infection","volume":"20","author":"Debast","year":"2014","journal-title":"Clin. Microbiol. 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