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Updated: Jan 24, 2026

Assessment of Intestinal Transcytosis of Neonatal Escherichia coli Bacteremia Isolates
Published on: February 17, 2023
Multidrug-Resistant Escherichia coli Resulting in Postpartum Necrotizing Endomyometritis
Joan Tymon-Rosario1, Meleen Chuang1,2
1Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, USA.
Background:
Postpartum endometritis is a fairly common postoperative complication occurring in up to 11 percent of all cesarean deliveries. Multidrug-resistant pathogenic organism is increasingly a factor in postoperative source of infection. Postpartum endomyometritis from a multidrug-resistant Escherichia coli infection resulting in uterine is one such rare clinical circumstance where there is minimal information in the literature to guide its treatment and management.
Case:
A 29-year-old G1P0 who underwent a primary cesarean delivery for a failed induction of labor developed endomyometritis on post-op day one and was treated with multiple broad-spectrum antibiotic regimens. The source of infection was found to be multidrug-resistant Escherichia coli with uterine involvement and pelvic abscesses, requiring hysterectomy and drainage of pelvic abscesses. Severe uterine necrosis from this multidrug-resistant Escherichia coli infection was noted intraoperatively. After three weeks of antibiotic therapy, she had resolution of her infection.
Conclusion:
Multidrug-resistant Escherichia coli is a highly pathogenic organism that can cause endomyometritis, persistent bacteremia, and uterine necrosis, which necessitates definitive surgical management with hysterectomy to achieve resolution of the infection.
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