Medical Tourism and Postoperative Infections

A Systematic Literature Review of Causative Organisms and Empiric Treatment

Pablo Padilla, Priscilla Ly, Rachel Dillard, Stefanos Boukovalas, Ramon Zapata Sirvent, Linda Phillips

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Medical tourism has become increasingly globalized as individuals travel abroad to receive medical care. Cosmetic patients in particular are more likely to seek surgery abroad to defray costs. Unfortunately, not all procedures performed abroad adhere to strict hygienic regulations, and bacterial flora vary. As a result, it is not uncommon for consumers to return home with difficult-to-treat postoperative infections. METHODS: A systematic literature review of PubMed, Ovid, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases was performed to assess the microbiology patterns and medical management of patients with postoperative infections after undergoing elective surgery abroad. RESULTS: Forty-two cases of postoperative infections were reported among patients who underwent elective surgery abroad. Most cases were reported from the Dominican Republic, and the most common elective procedures were abdominoplasty, mastopexy, and liposuction. Rapidly growing mycobacteria such as Mycobacterium abscessus, Mycobacterium fortuitum, and Mycobacterium chelonae were among the most common causes of postoperative infection, with M. abscessus involving 74 percent of cases. Most cases were treated with surgical débridement and a combination of antibiotics. Clarithromycin, amikacin, and moxifloxacin were the most common drugs used for long-term treatment. CONCLUSIONS: When encountering a patient with a history of medical tourism and treatment-refractory infection, rapidly growing mycobacteria must be considered. To increase the likelihood of yielding a diagnostic organism, multiple acid-fast bacilli cultures from fluid and débridement content should be performed. There has been reported success in treating rapidly growing mycobacterial infections with a combination of antibiotics including clarithromycin, amikacin, and moxifloxacin.

Original languageEnglish (US)
Pages (from-to)1644-1651
Number of pages8
JournalPlastic and Reconstructive Surgery
Volume142
Issue number6
DOIs
StatePublished - Dec 1 2018
Externally publishedYes

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Medical Tourism
Mycobacterium
Infection
Clarithromycin
Amikacin
Therapeutics
Mycobacterium chelonae
Dominican Republic
Mycobacterium fortuitum
Abdominoplasty
Anti-Bacterial Agents
Lipectomy
Microbiology
PubMed
Cosmetics
Bacillus
Nursing
Databases
Costs and Cost Analysis
Acids

ASJC Scopus subject areas

  • Surgery

Cite this

Medical Tourism and Postoperative Infections : A Systematic Literature Review of Causative Organisms and Empiric Treatment. / Padilla, Pablo; Ly, Priscilla; Dillard, Rachel; Boukovalas, Stefanos; Zapata Sirvent, Ramon; Phillips, Linda.

In: Plastic and Reconstructive Surgery, Vol. 142, No. 6, 01.12.2018, p. 1644-1651.

Research output: Contribution to journalArticle

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