Infections seen after overseas cosmetic surgery

Twelve women from the U.S. who had cosmetic surgery in the Dominican Republic developed a rare bacterial skin infection, according to the Centers for Disease Control and Prevention.

Authorities said that people who have recently undergone cosmetic surgery in the Dominican Republic should contact their local public health department if they notice any skin problems.

The infection is caused by Mycobacterium abscessus, a bacterium that causes pus to collect under the skin that needs to be drained. Other symptoms, which typically appeared weeks after surgery, include swelling, warmth and tenderness around the site of infection.

According to CDC investigators, some patients developed several abscesses, and had to return to the hospital repeatedly to have them drained. In some cases, patients needed to be hospitalized, and not all patients have completely healed.

"When you go in for surgery, you shouldn't come out with abscesses," co-investigator Dr. Dan Jernigan told Reuters Health.

Indeed, some of the patients "were not very happy," co-investigator Dr. Conception Estivariz added.

Most people will need antibiotics to recover fully, they advised.

Jernigan and Estivariz noted that they are currently investigating the facilities in the Dominican Republic where the infections occurred, and trying to determine its source.

According to their report, published in the Morbidity and Mortality Weekly Report, the 12 infected patients underwent a range of cosmetic procedures, including tummy tuck, liposuction, breast lift and breast reduction. All procedures took place in Santo Domingo between May 2003 and February 2004.

Five patients are residents of New York, and the others live in Massachusetts, North Carolina, Rhode Island and Puerto Rico.

Although the source of the infection remains unknown, Estivariz explained in an interview that the bacterium can grow in a disinfectant solution, and hospital workers may have washed surgical instruments in a contaminated solution.

Hospitals have strict guidelines and procedures to make sure patients do not become infected with this or other types of bacteria, she said. It is possible, however, that the institutions where patients picked up the bug did not follow the guidelines or something became contaminated without anyone knowing it, Estivariz noted.

"Right now, we are not sure what the source is," she said.

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SOURCE: Morbidity and Mortality Weekly Report, June 18, 2004.