| Summary: | Surgical site infection (SSI) following caesarean section is associated with increased morbidity, mortality, and significant health care costs. This study evaluated the epidemiological, clinical, and microbiological features of <i>Acinetobacter</i> spp. in women with SSIs who have undergone caesarean section at a referral hospital in the Brazilian Amazon region. This study included 69 women with post-caesarean SSI by <i>Acinetobacter</i> spp. admitted to the hospital between January 2012 and May 2015. The 69 <i>Acinetobacter</i> isolates were subjected to molecular species identification, antimicrobial susceptibility testing, detection of carbapenemase-encoding genes, and genotyping. The main complications of post-caesarean SSI by <i>Acinetobacter</i> were inadequate and prolonged antibiotic therapy, sepsis, prolonged hospitalization, and re-suture procedures. <i>A. baumannii</i>, <i>A. nosocomialis</i> and <i>A. colistiniresistens</i> species were identified among the isolates. Carbapenem resistance was associated with OXA-23-producing <i>A. baumannii</i> isolates and IMP-1-producing <i>A. nosocomialis</i> isolate. Patients with multidrug-resistant <i>A. baumannii</i> infection showed worse clinical courses. Dissemination of persistent epidemic clones was observed, and the main clonal complexes (CC) for <i>A. baumannii</i> were CC231 and CC236 (Oxford scheme) and CC1 and CC15 (Pasteur scheme). This is the first report of a long-term <i>Acinetobacter</i> spp. outbreak in women who underwent caesarean section at a Brazilian hospital. This study demonstrates the impact of multidrug resistance on the clinical course of post-caesarean infections.
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