New York and New Jersey are among 12 states implicated in a small outbreak of an “extensively” drug-resistant bacteria, according to an alert released Wednesday evening 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 type of bacteria commonly found in freshwater, soil and other environmental settings.
But in recent years, antibiotic-resistant forms of the bacteria have become a scourge of health care settings because it easily survives on surfaces, forming “biofilms” on equipment and devices. It can also spread via contaminated hands. To cause an infection, the germ must get through the skin — via a needle stick during an IV, for example, or via an organ transplant.
But Pseudomonas aeruginosa can also invade the body through a person’s wet, skinless mucosal eyes. These infections are typically seen when people wear contact lenses for too long.
Of the 55 cases identified so far, 35 patients are linked to clusters in four health care facilities. So far, one patient has died, and others have been hospitalized or suffered permanent vision loss.
Many but not all of the patients developed eye infections, and most used artificial tears or lubricating eye drops. Although patients told investigators about more than 10 different brands, the most common was EzriCare Artificial Tears.
“Patients and health care providers should immediately stop the use of EzriCare Artificial Tears pending additional information and guidance from CDC and FDA,” the CDC stated.
The CDC said subsequent testing of opened EzriCare bottles detected a strain of Pseudomonas aeruginosa that’s resistant to a dozen antimicrobial drugs. But federal health investigators found the germ is still susceptible to the antibiotic cefiderocol. The CDC said it continues to test unopened bottles to see if the contamination occurred during the manufacturing process.
In a statement posted on its website on Wednesday, EzriCare wrote that its Artificial Tears product is manufactured in India by Global Pharma Healthcare PVT Limited and imported into the U.S. by Aru Pharma Inc. The company is based in Lakewood, New Jersey.
“EzriCare LLC’s only role in introducing the product to the market was to design an exterior label and to 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 be initiating a recall of the product.”
The company said that 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 them if they’ve recently used EzriCare Artificial Tears.
Pseudomonas aeruginosa is one of several bacteria known to gain the ability of drug resistance. According to CDC data, multidrug-resistant forms of Pseudomonas aeruginosa hospitalized 32,600 people in 2017 and killed 2,700.
The same report shows that ahead of the COVID-19 pandemic, rates of this germ were dropping due to infection control efforts. But it and other antibiotic-resistant germs rebounded 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.