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Artificial tears products traced to drug-resistant infection outbreak in 12 states

WHATCOM COUNTY, Wash. — The Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) Health Advisory after 55 patients across 12 states, including Washington, were found to have infections with an extensively drug-resistant strain of Pseudomonas aeruginosa (VIM-GES-CRPA).

Most patients reported using artificial tears. Patients reported more than 10 different brands of artificial tears, and some patients used multiple brands. The majority of patients who used artificial tears reported using EzriCare Artificial Tears, a preservative-free, over-the-counter product packaged in multidose bottles. CDC laboratory testing identified the presence of the outbreak strain in opened EzriCare bottles with different lot numbers collected from two states. Patients and healthcare providers should immediately discontinue using EzriCare artificial tears pending additional guidance from CDC and the Food and Drug Administration (FDA).

As of January 31, 2023, CDC in partnership with state and local health departments identified 55 case-patients in 12 states (CA, CO, CT, FL, NJ, NM, NY, NV, TX, UT, WA, WI) with VIM-GES-CRPA, a rare strain of extensively drug-resistant P. aeruginosa. Thirty-five patients are linked to four healthcare facility clusters. Dates of specimen collection were from May 2022 to January 2023. Isolates have been identified from clinical cultures of sputum or bronchial wash (13), cornea (11), urine (7), other nonsterile sources (4), blood (2), and from rectal swabs (25) collected for surveillance; some patients had specimens collected from more than one anatomic site. CDC Health Alert Network advisory (February 1, 2023)

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It has been reported that some patients have suffered permanent vision loss resulting from cornea infection and, in 1 case, death due to systemic infection.

The following recommendations for the public were included in the CDC advisory.

  • Discontinue using EzriCare Artificial Tears pending additional guidance from CDC and FDA.
  • If patients were advised to use EzriCare Artificial Tears by their healthcare provider, they should follow up with their healthcare provider for an alternative artificial tears product to use.
  • Patients who used EzriCare Artificial Tears and who have signs or symptoms of an eye infection, such as discharge from the eye, eye pain or discomfort, redness of the eye or eyelid, feeling of something in the eye, increased sensitivity to light, or blurry vision, should seek timely medical care. At this time, CDC does not recommend testing of patients who have used this product and who are not experiencing any signs or symptoms of infection.
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