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 and Prevention is also investigating the cases in Utah, as well as in several other states.

According to the health department, about half 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. As a result, patients may have been exposed to bacterial infections and blood-borne infections.

The state health department and CDC warned Americans not to have surgery — including weight-loss surgery — at Grand View Hospital. And the agencies advised anyone who had surgery in Tijuana during or after August 2018 who are experiencing fever, redness, or pus, drainage or swelling from the surgical incision to seek medical care “immediately” because “serious complications may result without prompt treatment.”

Further, the release urges anyone who had surgery in Tijuana during or after August 2018 — even those who have no such symptoms — to contact a health care provider “immediately” about getting tested for HIV, hepatitis B and hepatitis C.