By IDSE News Staff
The CDC reported an outbreak of Pseudomonas aeruginosa linked to artificial tear products in 12 states, so far.
The agency recommended health providers immediately discontinue using EzriCare Artificial Tears pending additional guidance from the CDC and FDA because the product was extensively drug-resistant, according to the CDC’s Health Alert Network Health Advisory.
On Feb. 1, the CDC issued the advisory to inform the public of infections with an extensively drug-resistant strain of Verona integron–mediated metallo-beta-lactamase (VIM) and Guiana extended-spectrum beta-lactamase (GES)-producing carbapenem-resistant P. aeruginosa (VIM-GES-CRPA) in 12 states: California, Colorado, Connecticut, Florida, New Jersey, New Mexico, New York, Nevada, Texas, Utah, Washington and Wisconsin.
The combination of isolates in this outbreak had not been observed in the United States before this (sequence type 1203, harbor blaVIM-80 and blaGES-9). The isolates are not susceptible to cefepime, ceftazidime, piperacillin-tazobactam, aztreonam, carbapenems, ceftazidime-avibactam, ceftolozane-tazobactam (Zerbaxa, Merck), fluoroquinolones, polymyxins, amikacin, gentamicin or tobramycin. However, the CDC noted a subset of three isolates that underwent antimicrobial susceptibility testing for cefiderocol (Fetroja, Shionogi) were susceptible to tobramycin.
The presence of the outbreak strain was detected in multiple lots of bottles collected from two states, New York and New Jersey. As of Jan. 31, the CDC has identified 55 case patients.
Most of the affected patients reported using artificial tear products. More than 10 brands were identified, but the most commonly used one was EzriCare Artificial Tears, which is available preservative-free over the counter. The outbreak strain was identified by CDC laboratory testing of opened EzriCare bottles.
According to the CDC, patients had various presentations including keratitis, endophthalmitis, respiratory infection, urinary tract infection and sepsis. So far, patient outcomes include cornea infection resulting in permanent loss of vision, hospitalization, and one patient has died due to systemic infection.
Patients with signs or symptoms of an eye infection who have used preservative-free EzriCare Artificial Tears should seek medical care immediately.
Symptoms include:
- yellow, green or clear discharge from the eye;
- eye pain or discomfort;
- redness of the eye or eyelid;
- feeling of something in your eye (foreign body sensation);
- increased sensitivity to light; and
- blurry vision.
The CDC recommended providers treating patients for keratitis or endophthalmitis should inquire about the use of EzriCare Artificial Tears and consider performing culture and antimicrobial susceptibility testing to guide treatment if their patient does report use.
Presently, the CDC is only recommending testing symptomatic patients who have used this product.
From CDC materials.
