Vanegas Johanna Marcela, Higuita Luis Felipe, Vargas Carlos Andrés, Cienfuegos Astrid Vanessa, Rodríguez Érika Andrea, Roncancio Gustavo Eduardo, Jiménez Judy Natalia
Grupo de Microbiología Molecular, Grupo de Microbiología Básica y Aplicada, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia.
Clínica CardioVid, Medellín, Colombia.
Biomedica. 2015 Oct-Dec;35(4):522-30. doi: 10.7705/biomedica.v35i4.2572.
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.
To describe the clinical and molecular characteristics of infections caused by carbapenem-resistant A. baumannii in Medellín hospitals.
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.
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.
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.
鲍曼不动杆菌是一种机会致病菌，可感染重症患者，尤其是患有呼吸机相关性肺炎和菌血症的患者。对碳青霉烯类药物耐药性的出现限制了由该细菌引起的感染的治疗选择。
描述麦德林市医院中耐碳青霉烯鲍曼不动杆菌感染的临床和分子特征。
在麦德林市的五家医院进行了为期两年的横断面描述性研究。从患者病历中获取临床信息。通过三维试验和聚合酶链反应评估碳青霉烯酶的存在情况。使用脉冲场凝胶电泳（PFGE）和多位点序列分型（MLST）进行分子分型。
该研究纳入了32例患者，其中13例出现皮肤和软组织感染（n = 7，21.9%）或骨髓炎（n = 6，18.7%）。除黏菌素和替加环素外，所有评估的抗生素对分离株的耐药率均超过80%。在所有分离株中均检测到碳青霉烯酶OXA - 23和OXA - 51以及插入序列IS Aba1。PFGE显示分离株具有高度的遗传多样性，MLST表明克隆ST229和ST758在该市传播。
与先前的报告相反，本研究结果表明，骨髓炎以及皮肤和软组织感染是麦德林市医院中耐碳青霉烯鲍曼不动杆菌引起的主要感染，并揭示了其作为此类感染病原体的重要性。
