Wash. resident goes to Mexico for surgery, returns with rare, possibly deadly infection

by Karina Mazhukhina / KOMO News

Pseudomonas aeruginosa bacteria (Credit: U.S. Centers for Disease Control and Prevention – Medical Illustrator)

What started as a low-cost medical surgery in Tijuana, Mexico turned into one Washington resident developing a rare infection from a potentially deadly strain of bacteria.

As of noon Thursday, the Centers for Disease Control reports three suspected and 12 confirmed cases of the infection across America, including Arkansas, Arizona, Oregon, Utah, Texas, Virginia, and two in Washington state.

The bacteria, known as Pseudomonas aeruginosa, can cause serious infections in hospital patients or those with weakened immune systems, according to the CDC. The bacteria is becoming more resistant to antibiotics, making the infection harder to treat.

Eight of the travelers had surgery at Grand View Hospital in Tijuana, where doctors offer weight loss surgeries for a few thousand dollars, according to the hospital’s website. The average cost of gastric bypass surgery in America is $23,000 – the hospital in Tijuana offers it for $3,999.

The Mexican government closed the hospital until further notice, with the CDC recommending travelers to not have surgeries at that hospital until the government can confirm that the bacteria is no longer there.

Among the 15 cases reported, 13 were between August and December of 2018. There was also one case from 2015 and another from 2017, said David Diagle with the CDC.

Reporting also did not focus on identifying cases prior to fall 2018, so those from prior years might not have been reported, Diagle added.

“Healthy individuals are at low risk for acquiring this organism,” Diagle said. “However, we are concerned about these highly resistant bacteria spreading in healthcare settings.”

Patients in hospitals, especially those on breathing machines and those with wounds from surgery or from burns are potentially at risk for serious, life-threatening infections. The bacteria can spread on the hands of healthcare workers or by equipment that becomes contaminated and is not properly cleaned.

“When a patient is known to have a highly resistant bacteria, healthcare providers take special precautions, like wearing gowns and gloves and dedicating certain medical equipment to that patient’s use, to prevent spreading the bacteria to other patients,” Diagle said

(But) “If a patient is not recognized to be at risk for these resistant bacteria at the time of U.S. hospital admission, that increases the risk of spread,” he added.

Though there is still hope – patients can still recover fully from infections with these highly resistant bacteria, Diagle says.

“In other countries, there is precedent for this type of resistance to spread rapidly, with corresponding increases in the percent of infections that are resistant to an antibiotic,” Diagle said. In practice, this means that an antibiotic of choice like carbapenems (to treat the bacteria) can quickly become ineffective, which could leave providers with limited options that might be associated with bad side effects.

The CDC has confirmed one death, but it is still unclear whether it was tied to the infection — reporting that other health conditions were involved.

“In brief, it is important to note that medical and surgical procedures done anywhere, even in the United States, carry some risk and can result in complications,” Diagle said. “Persons traveling outside the U.S. for medical care should see a travel medicine specialist in the United States at least a month before their trip and should research the health care provider who will perform the procedure, as well as the clinic or hospital. Standards for providers and clinics abroad may be different from those in the United States.