Introducción: Clostridium difficile es una bacteria formadora de esporas, productoras de exotoxinas, causante de diarrea nosocomial potencialmente mortal. En fechas recientes se han reportado brotes de C. difficile ribotipo 027, la cual se caracteriza por ser una cepa hipervirulenta y de gran resistencia al tratamiento habitual.
Caso clínico: presentamos tres casos que fueron diagnosticados con Clostridium difficile cepa NAP1/027/BI, los cuales cursaron con diferentes cuadros clínicos. Dos de los pacientes fueron tratados exitosamente con la combinación de vancomicina más tigeciclina. El otro caso fue tratado con trasplante de microbiota fecal, con resolución de la enfermedad.
Conclusiones: en pacientes con infección asociada a Clostridium difficile cepa NAP1/027/BI, es una buena opción terapéutica el considerar el uso de tigeciclina en conjunto con vancomicina, así como el trasplante de microbiota fecal.
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