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4 Utahns who had surgery in Mexico are infected by drug-resistant bacteria. They’re also at risk for HIV and hepatitis.

At least four Utahns have been infected with antibiotic-resistant bacteria while having elective surgery in Mexico, and the Utah Department of Health is investigating other possible cases.

According to a news release, the infections have been traced to surgical procedures — mostly weight-loss surgery — in Tijuana. Patients returned to Utah infected with a drug-resistent form of Pseudomonas aeruginosa bacteria.

The Centers for Disease Control is also investigating the cases in Utah, as well as in several other states.

According to the health department, about half of the Americans infected had surgery at Grand View Hospital in Tijuana, where “poor infection-control practices” included “failure to appropriately clean and disinfect surgical instruments.