CDC warns of drug-resistant Pseudomonas at Tijuana hospital

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Takeaway

  • CDC is reporting that U.S. residents who underwent invasive medical procedures (mainly weight-loss surgery) in Tijuana, Mexico contracted carbapenem-resistant Pseudomonas aeruginosa (CRPA) infections.

Why this matters

  • Be vigilant for possibility of resistant infections occurring in patients who had medical procedures conducted abroad.
  • Obtain cultures, perform antimicrobial susceptibility treatment to guide treatment, test carbapenem-resistant bacteria for Verona integron, other plasmid-mediated carbapenemases.
  • Patients with histories of overnight stays in health care facilities outside the U.S. in past 6 months should undergo rectal screening for carbapenemase-producing organisms prior to hospitalization.
  • Consultation with infectious disease specialist is recommended.

Key points

  • ~50% of infected persons had surgery at Grand View Hospital, Tijuana.
  • Persons intending to have surgery at Grand View should delay plans until CDC can confirm that CRPA is no longer there.
  • Consider placing patients requiring hospitalization in isolation while awaiting screening results.
  • Carbapenem-resistant bacteria, rectal screening mechanism testing are available free of charge through the Antibiotic Resistance Network.
  • Clinicians are advised to familiarize themselves with additional CDC recommendations for patients planning to travel abroad for medical care.