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Medical tourists to Dominican Republic infected with non-TB mycobacteria, CDC warns
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The CDC has issued a warning concerning U.S. residents infected with nontuberculosis mycobacteria after undergoing cosmetic surgery in the Dominican Republic.
Most of the patients had undergone surgery at the Centro Internacional de Cirugia Plastica Avanzada (CIPLA) in Santo Domingo, the agency reported.
Eight state and city health departments in the U.S. reported cases of nontuberculosis mycobacteria (NTM) infection following procedures in the Caribbean nation, CDC spokeswoman Kate Fowlie told Infectious Disease News. The health departments of New York City and Pennsylvania have reported the most cases, she said, but those of Connecticut, Maryland, Massachusetts, Michigan, New Jersey and New York have also reported cases.
“At this point, because of the ongoing investigation, CDC cannot provide the number of [NTM] infections associated with cosmetic surgery in the Dominican Republic,” Fowlie said. “Most, but not all, of the patients had procedures performed at the [CIPLA]. Because few cases were reported from other clinics in the Dominican Republic, data are inadequate to identify the clinics as the sources of infection, and we are unable to disclose their names. As more information becomes available, we will update the travel notice at wwwnc.cdc.gov/travel/notices/alert/medical-tourism-dominican-republic.”
Symptoms of infections due to surgical wounds are likely to begin about a month after surgery, and can include pain, swelling, redness, drainage of fluid, fever, muscle aches and chills, among others, according to the CDC. An infection can worsen to the point at which another surgery is needed.
The CDC said clinicians should consider the possibility of NTM infection for all patients who have wound infections following surgery, including those that are not responsive to standard treatment. NTM are often resistant to antimicrobials, and clinicians may need to consult infectious disease specialists.
Some patients with NTM have acid fast-positive smears or tissue preparation but do not have bacteria in culture, the CDC noted. When dealing with a surgical wound infection, the agency advised, clinicians should collect specimens and make sure that the proper testing is performed.
Reference:
CDC. Nontuberculosis Mycobacteria Medical Tourists to the Dominican Republic. https://wwwnc.cdc.gov/travel/notices/alert/medical-tourism-dominican-republic. Accessed July 20, 2017.
*Editor's note: This story had been updated with information on the number of states and city health departments reporting cases of NTM.
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