New York and New Jersey are among 12 states involved in a minor outbreak of a “highly” resistant bacteria, according to an alert released Wednesday night by the Centers for Disease Control and Prevention. The CDC has linked several cases to EzriCare Artificial Tears, a brand of over-the-counter eye drops.
The germ is a rare, mutated strain of Pseudomonas aeruginosa, a type of bacteria commonly found in fresh water, soil and other environments.
But in recent years, antibiotic-resistant forms of the bacteria have become a health care scourge because it readily survives on surfaces and forms “biofilms” on equipment and devices. It can also spread through contaminated hands. To cause an infection, the germ must penetrate the skin, for example via a needle prick during an IV or via an organ transplant.
But Pseudomonas aeruginosa can also enter the body through a person’s wet, skinless mucous eyes. These infections are usually seen when people wear contact lenses for too long.
Of the 55 cases identified to date, 35 patients are linked to clusters in four healthcare facilities. So far, one patient has died and others have been hospitalized or suffered permanent vision loss.
Many but not all patients developed eye infections and most used artificial tears or lubricating eye drops. Although patients told researchers about more than 10 different brands, EzriCare Artificial Tears was the most common.
“Patients and healthcare providers should immediately discontinue use of EzriCare Artificial Tears pending additional information and guidance from CDC and FDA,” the CDC said.
The CDC said subsequent testing of opened EzriCare bottles detected a strain of Pseudomonas aeruginosa that is resistant to a dozen antimicrobial drugs. But federal health researchers found that the germ is still susceptible to the antibiotic cefiderocol. The CDC said it continues to test unopened bottles to see if contamination occurred during the manufacturing process.
In a statement posted to its website Wednesday, EzriCare wrote that its Artificial Tears product is manufactured in India by Global Pharma Healthcare PVT Limited and imported into the US by Aru Pharma Inc. The company is based in Lakewood, New Jersey.
“EzriCare LLC’s sole role in marketing the product was to design an outer label and market it to our customers,” the company stated. “We understand that the same product is also marketed under other brand names. We understand that Global Pharma Healthcare PVT Limited will initiate a recall of the product.”
The company said it is contacting customers to advise them not to use the product. The CDC said health care providers treating new or current patients with eye inflammation should ask them if they’ve recently used EzriCare Artificial Tears.
Pseudomonas aeruginosa is one of many bacteria known to acquire drug resistance. According to CDC data, multidrug-resistant forms of Pseudomonas aeruginosa hospitalized 32,600 people and killed 2,700 people in 2017.
The same report shows that prior to the COVID-19 pandemic, numbers of this germ were declining due to infection control efforts. But it and other antibiotic-resistant germs bounced back during the pandemic. The CDC estimates that more than 2.8 million antimicrobial-resistant infections occur each year, leading to more than 35,000 deaths.