RESUMO
BACKGROUND: Polymicrobial bacteremias with different biotypes of the same organism have not been reported as a cause of bacteremia in any patient. CASE: 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. CONCLUSION: 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.