January 2022

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 28, No. 1, January 2022

The articles of interest summarized below will appear in the January 2022 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature antimicrobial resistance. The articles are embargoed until December 15, 2021, at noon Eastern time.

Important Note: Most articles that EID publishes do not represent work done at CDC or by CDC staff. In your stories, please use our suggested language to clarify whether a study was conducted by CDC (“a CDC study”) or by another institution (“a study published by ____ in the EID journal”). Opinions expressed by authors contributing to EID do not necessarily reflect the opinions of CDC or the institutions with which the authors are affiliated.

Please link directly to the actual journal article in your stories. Once the embargo lifts, this month’s articles will be found in the Early Release section of the EID website.

EID is publishing many articles on the COVID-19 pandemic. Because we publish those articles on an expedited track, and we have no embargo on their content, we do not include them in these monthly press notices. You may wish to subscribe to receive email notifications when EID publishes expedited articles as well as other types of articles.

Note that the most recent EID COVID-19 papers are at the top of the journal’s home page and also included in the Coronavirus Spotlight.


Extensively Drug-Resistant, Carbapenemase-Producing Pseudomonas aeruginosa and Medical Tourism from United States to Mexico, 2018–2019, Ian Kracalik et al.

This paper looks at a large, prolonged outbreak of drug-resistant infections among U.S. medical tourists who underwent elective bariatric surgery in Mexico. Carbapenem-producing Pseudomonas aeruginosa are bacteria that are highly resistant to antibiotics. In the United States infections caused by these bacteria are most commonly associated with receipt of healthcare, although the strain identified in this outbreak remains rare.  Infectious disease outbreaks in U.S. medical tourists (people who travel internationally for the purpose of receiving medical care) have been previously reported. Medical tourism is popular for a number of reasons, including lower cost, shorter wait times, and fewer medical requirements. During 2018–2019, extensively drug-resistant, carbapenemase-producing Pseudomonas aeruginosa was identified in 38 U.S. residents who had undergone elective bariatric surgery (which typically involves removal of part of the stomach to help reduce food consumption and increase weight loss) in Tijuana, Baja California, Mexico; 31 by the same surgeon. Although the exact cause was not determined, proposed causes include lapses in infection control procedures at the facility or a contaminated medical device (laparoscope) that was transported between facilities. Alternative possibilities include a persistently contaminated environment or water at the facility or a healthcare worker who carried the bacteria, but did not have symptoms of illness, such as the surgeon. Despite warnings from U.S. public health agencies, medical tourists continued to undergo surgery at the same facility in early 2019. People considering medical tourism and U.S. healthcare providers caring for prospective or returned medical tourists should be aware that standards for infection control vary by country and facility, and that medical tourism carries the risk for infection with highly drug-resistant organisms not commonly encountered in the United States.

Contact: CDC Media Relations; phone (404) 639-3286 or email: media@cdc.gov

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES