<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0123-9392</journal-id>
<journal-title><![CDATA[Infectio]]></journal-title>
<abbrev-journal-title><![CDATA[Infect.]]></abbrev-journal-title>
<issn>0123-9392</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Infectología.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0123-93922019000100052</article-id>
<article-id pub-id-type="doi">10.22354/in.v23i1.756</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Ileostomía y lavado colónico anterógrado con Vancomicina en el manejo de infección por Clostridium difficile]]></article-title>
<article-title xml:lang="en"><![CDATA[Anterograde colonic lavage with Vancomycin via ileostomy for the management of Clostridium difficile infection. A case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rosso]]></surname>
<given-names><![CDATA[Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hormaza]]></surname>
<given-names><![CDATA[María Paula]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cedano]]></surname>
<given-names><![CDATA[Jorge Andrés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mora]]></surname>
<given-names><![CDATA[Bárbara Lucia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[Alberto Federico]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Fundación Valle del Lili Centro de Investigaciones Clínicas Servicio de Infectología]]></institution>
<addr-line><![CDATA[Cali Valle del Cauca]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Icesi Facultad de Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Fundación Valle del Lili Centro de Investigaciones Clínicas ]]></institution>
<addr-line><![CDATA[Cali Valle del Cauca]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>01</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>01</month>
<year>2019</year>
</pub-date>
<volume>23</volume>
<numero>1</numero>
<fpage>52</fpage>
<lpage>54</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0123-93922019000100052&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0123-93922019000100052&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0123-93922019000100052&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La infección por Clostridium difficile es la principal causa de diarrea asociada al cuidado de la salud. Durante los últimos años se ha incrementado la morbilidad y mortalidad por esta infección. Las recientes investigaciones se orientan a la búsqueda de tratamientos alternativos a la colectomía subtotal para los pacientes con infecciones severas por Clostridium difficile, es por esto que el presente artículo tiene como objetivo hacer la revisión del caso clínico de una paciente con colitis severa por Clostridium difficile refractaria al manejo de primera línea, que respondió satisfactoriamente al tratamiento con lavado colónico anterógrado con vancomicina vía ileostomía en asa.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Clostridium difficile infection is the main cause of diarrhea in health care settings. Such infections have led to an increase in morbidity and mortality in recent years. Alternative treatments to subtotal colectomy have been sought for patients with severe infections caused by Clostridium difficile. The objective of this article is to present a clinical case report of a patient with severe colitis caused by Clostridium difficile that was refractory to first-line management, which responded satisfactorily to treatment with anterograde colonic lavages with vancomycin via loop ileostomy.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Colitis]]></kwd>
<kwd lng="es"><![CDATA[Clostridium difficile]]></kwd>
<kwd lng="es"><![CDATA[Ileostomía en asa]]></kwd>
<kwd lng="es"><![CDATA[Colectomía]]></kwd>
<kwd lng="es"><![CDATA[Vancomicina]]></kwd>
<kwd lng="en"><![CDATA[Colitis]]></kwd>
<kwd lng="en"><![CDATA[Clostridium difficile]]></kwd>
<kwd lng="en"><![CDATA[Loop Ileostomy]]></kwd>
<kwd lng="en"><![CDATA[Colectomy]]></kwd>
<kwd lng="en"><![CDATA[Vancomycin]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[SH]]></given-names>
</name>
<name>
<surname><![CDATA[Gerding]]></surname>
<given-names><![CDATA[DN]]></given-names>
</name>
<name>
<surname><![CDATA[Johnson]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kelly]]></surname>
<given-names><![CDATA[CP]]></given-names>
</name>
<name>
<surname><![CDATA[Loo]]></surname>
<given-names><![CDATA[VG]]></given-names>
</name>
<name>
<surname><![CDATA[McDonald]]></surname>
<given-names><![CDATA[LC]]></given-names>
</name>
<name>
<surname><![CDATA[Pepin]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Wilcox]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[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)]]></article-title>
<source><![CDATA[Infect Control Hosp Epidemiol]]></source>
<year>2010</year>
<volume>31</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>431-55</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bauer]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Johnston]]></surname>
<given-names><![CDATA[JEW]]></given-names>
</name>
<name>
<surname><![CDATA[Wenzler]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Goff]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Cook]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Balada-Llasat]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Pancholi]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Mangino]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact of the NAP-1 strain on disease severity, mortality, and recurrence of healthcare-associated Clostridium difficile infection]]></article-title>
<source><![CDATA[Anaerobe]]></source>
<year>2017</year>
<volume>48</volume>
<page-range>1-6</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Debast]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
<name>
<surname><![CDATA[Bauer]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Kuijper]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection]]></article-title>
<collab>European Society of Clinical Microbiology and Infection</collab>
<source><![CDATA[Clin Microbiol Infect]]></source>
<year>2014</year>
<volume>20</volume>
<numero>^s2</numero>
<issue>^s2</issue>
<supplement>2</supplement>
<page-range>1-26</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Neal]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Alverdy]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Hall]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
<name>
<surname><![CDATA[Simmons]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Zuckerbraun]]></surname>
<given-names><![CDATA[BS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diverting loop ileostomy and colonic lavage: An alternative to total abdominal colectomy for the treatment of severe, complicated clostridium difficile associated disease]]></article-title>
<source><![CDATA[Annals of Surgery]]></source>
<year>2011</year>
<page-range>423-9</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dudukgian]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Sie]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Gonzalez-Ruiz]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Etzioni]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Kaiser]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[C. difficile colitis-predictors of fatal outcome]]></article-title>
<source><![CDATA[J Gastrointest Surg]]></source>
<year>2010</year>
<volume>14</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>315-22</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Surawicz]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Brandt]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Binion]]></surname>
<given-names><![CDATA[DG]]></given-names>
</name>
<name>
<surname><![CDATA[Ananthakrishnan]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Curry]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Gilligan]]></surname>
<given-names><![CDATA[PH]]></given-names>
</name>
<name>
<surname><![CDATA[McFarland]]></surname>
<given-names><![CDATA[LV]]></given-names>
</name>
<name>
<surname><![CDATA[Mellow]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Zuckerbraun]]></surname>
<given-names><![CDATA[BS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections]]></article-title>
<source><![CDATA[Am J Gastroenterol]]></source>
<year>2013</year>
<volume>108</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>478-98</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gash]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Brown]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Pullyblank]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Emergency subtotal colectomy for fulminant Clostridium difficile colitis--is a surgical solution considered for all patients?]]></article-title>
<source><![CDATA[Ann R Coll Surg Engl]]></source>
<year>2010</year>
<volume>92</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>56-60</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Longo]]></surname>
<given-names><![CDATA[WE]]></given-names>
</name>
<name>
<surname><![CDATA[Mazuski]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Virgo]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Bahadursingh]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Johnson]]></surname>
<given-names><![CDATA[FE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Outcome after colectomy for Clostridium difficile colitis]]></article-title>
<source><![CDATA[Dis Colon Rectum]]></source>
<year>2004</year>
<volume>47</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1620-6</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kautza]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Zuckerbraun]]></surname>
<given-names><![CDATA[BS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Surgical Management of Complicated Clostridium Difficile Infection: Alternatives to Colectomy]]></article-title>
<source><![CDATA[Surg Infect (Larchmt)]]></source>
<year>2016</year>
<volume>17</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>337-42</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ferrada]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Callcut]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Zielinski]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Bruns]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Yeh]]></surname>
<given-names><![CDATA[DD]]></given-names>
</name>
<name>
<surname><![CDATA[Zakrison]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
<name>
<surname><![CDATA[Meizoso]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Sarani]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Catalano]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: An Eastern Association for the Surgery of Trauma multicenter trial]]></article-title>
<source><![CDATA[J Trauma Acute Care Surg]]></source>
<year>2017</year>
<volume>83</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>36-40</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fashandi]]></surname>
<given-names><![CDATA[AZ]]></given-names>
</name>
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[PT]]></given-names>
</name>
<name>
<surname><![CDATA[Hedrick]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
<name>
<surname><![CDATA[Friel]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Smith]]></surname>
<given-names><![CDATA[PW]]></given-names>
</name>
<name>
<surname><![CDATA[Hays]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Hallowell]]></surname>
<given-names><![CDATA[PT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An institutional comparison of total abdominal colectomy and diverting loop ileostomy and colonic lavage in the treatment of severe, complicated Clostridium difficile infections]]></article-title>
<source><![CDATA[Am J Surg]]></source>
<year>2017</year>
<volume>213</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>507-11</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
