The CDC is alerting healthcare providers on highly antibiotic resistant infections with patients who underwent invasive procedures in Mexico. Are you screening your patients for recent international travel? What steps are you taking to prevent the spread of antibiotic resistant bacteria? In this post we discuss the latest CDC update and steps you can take to protect your patients.
In the last 8 months, the Centers for Disease Control and Prevention (CDC) has received eight reports of patients who have been infected with highly antibiotic-resistant Pseudomonas aeruginosa infections. These infections were reported from patients who underwent invasive procedures such as bariatric and plastic surgery in Mexico. According to the CDC, “the infections were caused by a strain of P. aeruginosa that expresses a carbapenemase called the Verona integron-encoded metallo-β-lactamase (VIM). P. aeruginosa expressing VIM (VIM-CRPA) are often resistant to all first-line antibiotics and can cause infections that are difficult to treat. VIM-CRPA isolates associated with the initial outbreak in Tijuana have been extensively drug resistant (XDR)”. There is no evidence of an outbreak linked to a specific facility or surgeon.
The CDC continues to advise patients that having surgery abroad greatly increases their risk of developing highly resistant infections that are not common in the United States. Patients who are considering surgery abroad are encouraged to read the CDC’s “Medical Tourism: Getting Medical Care in Another Country”. Further, patients who underwent surgery or endoscopy in another country and develop signs of infection are encouraged to seek medical care and disclose to the healthcare provider their history involving surgery in a foreign country.
How should facilities and healthcare providers care for these patients?
According to the CDC, caution must be taken when providing care to any patient who has had an invasive procedure in Mexico within the last year. How is your facility screening patients? With the ongoing COVID-19 pandemic, screening for international travel has become more commonplace, but that isn’t nearly enough. Remember that the look-back period is one year. Any patient who has traveled internationally, specifically to Mexico, should be further screened for any possible medical procedures performed during that time. To prevent the potential spread of highly resistant bacteria to other patients, providers should perform adequate screening, assessment and then follow CDC guidance. These highly resistant bacteria have the potential to spread rapidly in healthcare settings and proper management is critical.
Although ambulatory surgery centers may not encounter many of these patients, having a policy and procedure in place to screen all patients is absolutely necessary. Most of these infections are surgical incision site infections and if encountered, should be referred to an infectious disease specialist. Additionally, we all know, antibiotic stewardship is a critical component of a good infection control program. Facilities should have a dedicated infection preventionist who leads the team on proper infection control measures, including the use of antibiotics. This is a good opportunity to rely on your pharmacy consultant as an expert member of your team. Which antibiotics should you use and when? How about perioperative management of antibiotics? Do you have a plan to deal with prophylaxis and antibiotic timing? A highly qualified consultant pharmacist will point you in the right direction and provide guidance when unique circumstances arise. If you have questions about this topic, or need help with antibiotic stewardship, let us know and we will review your existing policies and help you not only meet, but exceed current standards.
The Consultant Pharmacists at OctariusRx provide guidance on safe medication management, survey readiness and cost savings to ambulatory healthcare facilities/surgery centers, senior care facilities and pharmacies. We also help individual patients optimize their medications to improve their quality of life and save money. Contact us for assistance.
