TY - JOUR AU - Kracalik, Ian AU - Ham, D. Cal AU - McAllister, Gillian AU - Smith, Amanda AU - Vowles, Maureen AU - Kauber, Kelly AU - Zambrano, Melba AU - Rodriguez, Gretchen AU - Garner, Kelley AU - Chorbi, Kaitlyn AU - Cassidy, P. Maureen AU - McBee, Shannon AU - Stoney, Rhett AU - Moser, Kathleen AU - Villarino, Margarita AU - Zazueta, Oscar AU - Bhatnagar, Amelia AU - Sula, Erisa AU - Stanton, Richard AU - Brown, Allison AU - Halpin, Alison AU - Epstein, Lauren AU - Walters, Maroya Spalding T1 - Extensively Drug-Resistant Carbapenemase-Producing Pseudomonas aeruginosa and Medical Tourism from the United States to Mexico, 2018–2019 T2 - Emerging Infectious Disease journal PY - 2022 VL - 28 IS - 1 SP - 51 SN - 1080-6059 AB - Carbapenem-resistant Pseudomonas aeruginosa (CRPA) producing the Verona integron‒encoded metallo-β-lactamase (VIM) are highly antimicrobial drug-resistant pathogens that are uncommon in the United States. We investigated the source of VIM-CRPA among US medical tourists who underwent bariatric surgery in Tijuana, Mexico. Cases were defined as isolation of VIM-CRPA or CRPA from a patient who had an elective invasive medical procedure in Mexico during January 2018‒December 2019 and within 45 days before specimen collection. Whole-genome sequencing of isolates was performed. Thirty-eight case-patients were identified in 18 states; 31 were operated on by surgeon 1, most frequently at facility A (27/31 patients). Whole-genome sequencing identified isolates linked to surgeon 1 were closely related and distinct from isolates linked to other surgeons in Tijuana. Facility A closed in March 2019. US patients and providers should acknowledge the risk for colonization or infection after medical tourism with highly drug-resistant pathogens uncommon in the United States. KW - outbreak KW - extensively drug-resistant KW - carbapenemase producing KW - Pseudomonas aeruginosa KW - bacteria KW - antimicrobial resistance KW - medical tourism KW - bariatric surgery KW - United States KW - Mexico DO - 10.3201/eid2801.211880 UR - https://wwwnc.cdc.gov/eid/article/28/1/21-1880_article ER - End of Reference