New Jersey

NY, NJ linked to outbreak of ‘extensively’ drug-resistant bacteria in eye drops

New York and New Jersey are among 12 states implicated in a small outbreak of a “broadly” drug-resistant bacterium, according to an alert released Wednesday night by the Centers for Disease Control and Prevention. The CDC has linked several of the cases to EzriCare Artificial Tears, a brand of over-the-counter eye drops.

The germ is a rare, mutant strain of Pseudomonas aeruginosa, a species of bacteria commonly found in freshwater, soil, and other environmental environments.

But in recent years, antibiotic-resistant forms of the bacterium have become a scourge of healthcare because they easily survive on surfaces and form “biofilms” on equipment and devices. It can also spread via contaminated hands. In order to trigger an infection, the germ must get through the skin – for example via a needle stick during an infusion or via an organ transplant.

But Pseudomonas aeruginosa can also enter the body through a person’s moist, mucous membraneless eyes. These infections typically occur when people wear contact lenses for too long.

Of the 55 cases identified so far, 35 patients are associated with clusters in four healthcare facilities. So far, one patient has died, others have been hospitalized or have suffered permanent vision loss.

Many, but not all, patients developed eye infections, and most used artificial tears or lubricating eye drops. Although patients told investigators about more than 10 different brands, EzriCare Artificial Tears was the most common.

“Patients and healthcare providers should stop using EzriCare Artificial Tears immediately pending additional information and guidance from the 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. However, federal health investigators found that the germ is still susceptible to the antibiotic cefiderocol. The CDC said it continues to test unopened bottles to determine if the contamination occurred during the manufacturing process.

In a statement published on its website on Wednesday, EzriCare wrote that its Artificial Tears product is manufactured in India by Global Pharma Healthcare PVT Limited and imported to the United States by Aru Pharma Inc. The company is based in Lakewood, NJ.

“EzriCare, LLC’s sole role in bringing the product to market was to design an outer label and market it to our customers,” the company said. “We are aware that the same product is also marketed under different brand names. We are aware that Global Pharma Healthcare PVT Limited will initiate a product recall.”

The company said it is contacting customers to advise them against using its product. The CDC said health care providers treating new or current patients with eye inflammation should ask if they have recently used EzriCare Artificial Tears.

Pseudomonas aeruginosa is one of several bacteria known to acquire drug resistance ability. Multidrug-resistant forms of Pseudomonas aeruginosa hospitalized 32,600 people and killed 2,700 in 2017, according to CDC data.

The same report shows that before the COVID-19 pandemic, rates of this germ were falling thanks to infection control efforts. But it and other antibiotic-resistant germs rebounded during the pandemic. The CDC estimates that more than 2.8 million antibiotic-resistant infections occur each year, resulting in more than 35,000 deaths.

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