ESCHERICHIA-COLI BACTEREMIA IN PATIENTS WITH AND WITHOUT HEMATOLOGICAL MALIGNANCIES - A STUDY OF STRAIN CHARACTERS AND RECURRENT EPISODES

We compared serotypes, virulence factors and susceptibility to antibio tics of Escherichia coli strains isolated from 282 patients with bacte raemia, Thirty-five of these were neutropenic patients with haematolog ical malignancy and 247 were patients with a normal or raised total wh ite blood cell count and no haematological malignancy, Strains isolate d from recurrent bacteraemia were also bio-and ribotyped. Overall, no significant difference was found between O serogroups, It antigens, se rum sensitivity, production of haemolysin, expression of P-fimbriae an d patterns of antibiotic susceptibility in the two groups of strains, The haematological patients more often than the nonhaematological pati ents had an unknown focus of infection, recurrent bacteraemia, shorter intervals between recurrences and recurrences caused by identical str ains. Despite a well-defined focus, six of eight non-haematological pa tients had recurrences with a strain different from the strain isolate d in a previous episode. A possible connection between shorter interva ls and recurrence with identical strains is discussed. We suggest that strains from recurrent E. coli bacteraemia are sent to a reference la boratory for serotyping and possibly ribotyping.