title: [Carbapenem-resistant Acinetobacter baumannii causing osteomyelitis and infections of skin and soft tissues in hospitals of Medellín, Colombia].
abstract: BACKGROUND
  Acinetobacter baumannii is an opportunistic bacterium which infects seriously ill patients, particularly those with ventilator-associated pneumonia and bacteremia. The emergence of resistance to carbapenem limits the options for the treatment of infections caused by this bacterium.
  
  
  OBJECTIVE
  To describe the clinical and molecular characteristics of infections caused by carbapenem-resistant A. baumannii in Medellín hospitals.
  
  
  METHODS
  A cross-sectional descriptive study was carried out in five Medellín hospitals over a 2-year period. Clinical information was obtained from medical histories of patients. The presence of carbapenemases was evaluated by three-dimensional test and PCR. Molecular typing was performed using PFGE and MLST.
  
  
  RESULTS
  The study included 32 patients, 13 of whom presented skin and soft tissue infections (n=7, 21.9%) or osteomyelitis (n=6, 18.7%). Resistance rates of the isolates exceeded 80% for all the antibiotics evaluated except colistin and tigecycline. Carbapenemases OXA-23 and OXA-51, as well as the insertion sequence IS Aba1 , were detected in all the isolates. PFGE revealed high genetic diversity in the isolates and MLST showed clones ST229 and ST758 are circulating in the city.
  
  
  CONCLUSIONS
  In contrast to previous reports, the results of the present study showed osteomyelitis and infections of skin and soft tissues to be the main infections caused by carbapenem-resistant A. baumannii in Medellín hospitals and revealed its importance as an etiological agent for this type of infections.
authors: Grupo de Microbiología Molecular, Grupo de Microbiología Básica y Aplicada, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia.
authors: Johanna Marcela
authors: JM
authors: Vanegas
authors: Grupo de Microbiología Molecular, Grupo de Microbiología Básica y Aplicada, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia.
authors: Luis Felipe
authors: LF
authors: Higuita
authors: Grupo de Microbiología Molecular, Grupo de Microbiología Básica y Aplicada, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia.
authors: Carlos Andrés
authors: CA
authors: Vargas
authors: Grupo de Microbiología Molecular, Grupo de Microbiología Básica y Aplicada, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia.
authors: Astrid Vanessa
authors: AV
authors: Cienfuegos
authors: Grupo de Microbiología Molecular, Grupo de Microbiología Básica y Aplicada, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia.
authors: Érika Andrea
authors: ÉA
authors: Rodríguez
authors: Clínica CardioVid, Medellín, Colombia.
authors: Gustavo Eduardo
authors: GE
authors: Roncancio
authors: Grupo de Microbiología Molecular, Grupo de Microbiología Básica y Aplicada, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia.
authors: Judy Natalia
authors: JN
authors: Jiménez
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003105:Colombia / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000453:epidemiology / Q000382:microbiology; D010019:Osteomyelitis / Q000453:epidemiology* / Q000382:microbiology; D017192:Skin Diseases, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics
chemical_list: C466679:beta-lactamase OXA-23; D001618:beta-Lactamases; C577373:beta-lactamase OXA-51, Acinetobacter baumannii