Eyedrop Recall: 2 More Deaths, 4 People Had Eyeball Removed Due to Bacteria
The outbreak is considered particularly worrisome because the bacteria driving it is resistant to standard antibiotics.
By: AP
US officials are reporting two more deaths and additional cases of vision loss linked to eyedrops tainted with a drug-resistant bacteria.
The eyedrops from EzriCare and Delsam Phama were recalled in February and health authorities are continuing to track infections as they investigate the outbreak.
In the latest government tally, 68 people were diagnosed with infections from the bacteria, which has now caused a total of three deaths and eight cases of people losing their vision, the Centers for Disease Control and Prevention reported on Tuesday. That’s up from one death and five cases of permanent vision loss reported last month.
The CDC said four people have undergone surgery to remove an eyeball due to the infections.
The outbreak is considered particularly worrisome because the bacteria driving it is resistant to standard antibiotics.
The CDC has now identified cases in 16 states, including California, New York, Illinois, Texas and Pennsylvania. Most of the cases have been linked to four regional clusters and Ezricare’s drops are the only product used by patients in each of those groups.
The recalled drops were manufactured by Global Pharma Healthcare in India, where the bacteria — Pseudomonas aeruginosa — is commonly linked to outbreaks in hospitals. It can spread through contaminated hands or medical equipment.
How officials cracked case of eyedrops that blinded people
The investigation started in May in Los Angeles County, California. A patient who’d recently been to an ophthalmologist came in with a bad eye infection. A month later, local health officials got a second report. Another bad eye infection, same eye doctor.
Two more cases were reported in the county before the summer was over. The patients’ eyes were inflamed with heavy yellow pus that obscured most of the pupil. Among the four, two had complete vision loss in the affected eye.
The hospital that reported the first infection determined it was caused by a bacteria called Pseudomonas aeruginosa. The institution, which was equipped to do advanced genetic testing, quickly realized the bacteria had a rare gene that protected it from the effects of commonly used antibiotics.
It was an early break for investigators, said Kelsey OYong, of the Los Angeles County Department of Public Health.
OYong and her colleagues knew they were dealing with a scary germ, and they notified the Centers for Disease Control and Prevention.
Pseudomonas infections are not new. Drug-resistant strains of the bacteria cause more than 30,000 infections annually among hospitalized patients in the U.S. and more than 2,500 deaths, the CDC said. It can spread through contaminated hands or medical equipment, and is particularly dangerous to fragile patients who have catheters or are on breathing machines.
But the California infections were in patients’ eyes, not more common spots like the blood and lungs. Also, the lab analysis determined the infections were caused by a Pseudomonas germ that could resist just about every antibiotic.
The only thing that worked was a newer antibiotic called cefiderocol, administered by IV.
Over the summer, Pseudomonas outbreaks were seen at long-term care facilities in two other states.
In Connecticut, the first case was in June. Eventually, the bacteria was found in 25 patients from five nursing homes in different parts of the state, said Christopher Boyle, a spokesperson for Connecticut’s health department.
In Davis County, Utah, north of Salt Lake City, the first of six cases was reported to the CDC in August. While the patients had the bacteria, none actually got sick, said Sarah Willardson of the Davis County Health Department.
L.A. County health investigators thought the cases there might be due to some kind of equipment contamination at the eye doctor’s office.
But that suspicion faded in early October, when genetic testing showed the clusters in California, Connecticut and Utah were all caused by the same bacteria strain — a version of the germ that hadn’t been seen anywhere before.
“That made us start thinking that this was some kind of a product,” said Maroya Walters, the CDC official supervising the investigation.
As the year went on, other reports of drug-resistant Pseudomonas came in, including a Washington man who died with a bloodstream infection.
Given the initial cluster at the California ophthalmologist’s office, investigators suspected an eye care product was the culprit, though that hypothesis was complicated by the fact that the infections at the long-term care facilities were mainly found in the lungs.
But it wasn’t impossible. Tear ducts drain into the nasal cavity, which leads to the lungs and could provide a path to deep inside the body.
In early November, investigators determined most of the infected Connecticut patients had been given artificial tears, though it wasn’t clear who had been given which brand.
Then, on Nov. 9, a Florida hospital contacted the CDC to report bad eye infections connected to an outpatient clinic. A check of artificial tears brands used in Connecticut, Florida and Utah pointed to one common product: EzriCare Artificial Tears, an over-the-counter product marketed in the U.S. by New Jersey-based EzriCare LLC and made in India by Global Pharma Healthcare. (AP)
