The Utah Department of Health (UDOH) and Centers for Disease Control and Prevention (CDC) are investigating reports of infections caused by an antibiotic-resistant form of Pseudomonas aeruginosa bacteria in patients who had surgery at Grand View Hospital in Tijuana, Mexico during or after August 2018. As part of this investigation, poor infection control practices were identified at the hospital, including failure to appropriately clean and disinfect surgical instruments. As a result, patients may have been exposed to other bacterial infections and bloodborne infections (transmitted through exposure to blood).
The UDOH and CDC recommend that travelers to Mexico not have surgery (including weight-loss surgery) at Grand View Hospital in Tijuana. Neither the UDOH nor CDC has authority to assure quality of care or patient safety in Mexico or any international hospitals. Patients considering surgery in foreign countries should consider the associated risks. Contact the Healthcare-Associated Infections/Antimicrobial Resistance (HAI/AR) Program at 801-538-6191 for more information.
Last updated 06/19/19
|Outbreak-associated cases in Utah||8|
|Onset Date Range||August 2018-June 2019|
- If you had surgery in Mexico during or after August 2018, talk to your healthcare provider about getting tested for the following bloodborne infections, regardless of symptoms:
- hepatitis C virus
- hepatitis B virus
- human immunodeficiency virus (HIV).
- If you are experiencing any of the following signs of infection after surgery in Mexico, seek medical care immediately as serious complications may result without prompt treatment:
- pus or drainage from the surgical incision site
- swelling at the surgical incision site.
For more information, visit Bacterial Infections in Patients Who Had Surgery in Mexico.
- Providers should report any cases of Pseudomonas aeruginosa in patients with surgical site infections who report a history of surgery in Tijuana, Mexico to their local health department or the HAI/AR program at 801-538-6191.
- Providers should check with patients who had surgery in Tijuana, Mexico since August 2018. If so, the provider should recommend testing for hepatitis B, hepatitis C and HIV, based on the risks associated with breaches in surgical instrument cleaning and disinfection.
- Wound cultures should be collected from any patient with a surgical site infection and history of surgery in Tijuana, Mexico within the last six months.
- Carbapenem-resistant Pseudomonas aeruginosa (CRPA) isolates should be submitted to the Utah Public Health Laboratory (UPHL) to undergo mechanism testing for VIM and other plasmid-mediated carbapenemases.
- Mechanism testing for carbapenem-resistant Enterobacteriaceae (CRE) and CRPA is available free of charge via the Antibiotic Resistance Laboratory Network, which can also be accessed through the CDC's State-based HAI Prevention page.
- Contact the HAI/AR Program at 801-538-6191 for details about CRE and CRPA testing.
- Healthcare providers should utilize contact precautions when caring for patients with suspected VIM-CRPA.
- Patients with highly-resistant* CRPA isolated from a surgical site infection or wound should be asked about receipt of healthcare outside the U.S. (both elective [medical tourism] and unplanned care) in the six months prior to a positive culture.
- *Highly resistant = CRPA that is resistant to all but one or two antibiotic treatment regimens