title: Multistate US Outbreak of Rapidly Growing Mycobacterial Infections Associated with Medical Tourism to the Dominican Republic, 2013-2014(1).
abstract: During 2013, the Maryland Department of Health and Mental Hygiene in Baltimore, MD, USA, received report of 2 Maryland residents whose surgical sites were infected with rapidly growing mycobacteria after cosmetic procedures at a clinic (clinic A) in the Dominican Republic. A multistate investigation was initiated; a probable case was defined as a surgical site infection unresponsive to therapy in a patient who had undergone cosmetic surgery in the Dominican Republic. We identified 21 case-patients in 6 states who had surgery in 1 of 5 Dominican Republic clinics; 13 (62%) had surgery at clinic A. Isolates from 12 (92%) of those patients were culture-positive for Mycobacterium abscessus complex. Of 9 clinic A case-patients with available data, all required therapeutic surgical intervention, 8 (92%) were hospitalized, and 7 (78%) required ≥3 months of antibacterial drug therapy. Healthcare providers should consider infection with rapidly growing mycobacteria in patients who have surgical site infections unresponsive to standard treatment.
authors.forename: David
authors.initials: D
authors.lastname: Schnabel
authors.forename: Douglas H
authors.initials: DH
authors.lastname: Esposito
authors.forename: Joanna
authors.initials: J
authors.lastname: Gaines
authors.forename: Alison
authors.initials: A
authors.lastname: Ridpath
authors.forename: M Anita
authors.initials: MA
authors.lastname: Barry
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Feldman
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Mullins
authors.forename: Rachel
authors.initials: R
authors.lastname: Burns
authors.forename: Nina
authors.initials: N
authors.lastname: Ahmad
authors.forename: Edith N
authors.initials: EN
authors.lastname: Nyangoma
authors.forename: Duc B
authors.initials: DB
authors.lastname: Nguyen
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Perz
authors.forename: Heather A
authors.initials: HA
authors.lastname: Moulton-Meissner
authors.forename: Bette J
authors.initials: BJ
authors.lastname: Jensen
authors.forename: Ying
authors.initials: Y
authors.lastname: Lin
authors.forename: Leah
authors.initials: L
authors.lastname: Posivak-Khouly
authors.forename: Nisha
authors.initials: N
authors.lastname: Jani
authors.forename: Oliver W
authors.initials: OW
authors.lastname: Morgan
authors.forename: Gary W
authors.initials: GW
authors.lastname: Brunette
authors.forename: P Scott
authors.initials: PS
authors.lastname: Pritchard
authors.forename: Adena H
authors.initials: AH
authors.lastname: Greenbaum
authors.forename: Susan M
authors.initials: SM
authors.lastname: Rhee
authors.forename: David
authors.initials: D
authors.lastname: Blythe
authors.forename: Mark
authors.initials: M
authors.lastname: Sotir
mesh_terms: D000293:Adolescent; D000328:Adult; D004196:Disease Outbreaks; D004293:Dominican Republic / Q000453:epidemiology; D005260:Female; D006801:Humans; D057193:Medical Tourism; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology* / Q000382:microbiology*; D000073358:Mycobacterium abscessus; D013518:Surgery, Plastic / Q000009:adverse effects; D013530:Surgical Wound Infection; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Dominican Republic; Mycobacteria; Mycobacterium abscessus complex; Mycobacterium chelonae; Mycobacterium fortuitum; United States; antibacterial drugs; antibiotic; antimicrobial resistance; bacteria; cosmetic surgery; healthcare-associated infections; medical tourism; nontuberculous mycobacteria; nosocomial infections; rapidly growing mycobacteria; tourist