Septicemia due to multiple biotypes of Escherichia coli.

Abstract

Polymicrobial bacteremias with different biotypes of the same organism have not been reported as a cause of bacteremia in any patient. A 37-year-old gravida had a cesarean delivery performed after a failed vacuum extraction. On the second postoperative day, she developed a septicemia with temperature to 39.4C. Three different biotypes of Escherichia coli with different antibiotic susceptibilities were isolated from her blood. A fourth biotype was isolated from the urinary and genital tracts; therefore, the source of her bacteremia was not apparent. She was treated successfully with cefoxitin and gentamicin. Accurate selection of colonies from microbiological isolation plates allowed identification of four different E. coli biotypes (three in the blood) from a bacteremic patient. Rapid identification of antibiotic susceptibility is important in such patients.