An Eye Drop May Have Introduced Dangerous Bacteria to US, Expert Advises How to Prevent

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The U.S. Centers for Disease Control and Prevention (CDC) has linked fatalities and incidents of blindness to a tainted eye drop imported from India. The agency has expressed fears that the bacteria responsible could spread from person to person in health care settings.

New Pseudomonas Aeruginosa Has Potential to Spread Rapidly in Health Care Settings

On March 21, the CDC reported that it was collaborating with the U.S. Food and Drug Administration (FDA) and state and local health departments to investigate a multistate outbreak of extensively drug-resistant bacteria: Pseudomonas aeruginosa.

The bacteria are associated with multiple types of infections, including eye infections. Investigators suspect certain brands of artificial tears as a common exposure for many patients.

The CDC and FDA currently recommend clinicians and patients stop using EzriCare or Delsam Pharma’s Artificial Tears products.

The outbreak strain, called carbapenem-resistant Pseudomonas aeruginosa with Verona integron-mediated metallo-beta-lactamase and Guiana extended-spectrum-beta-lactamase (VIM-GES-CRPA), had never been reported in the United States before this outbreak.

“As of March 14, 2023, CDC, in partnership with state and local health departments, identified 68 patients in 16 states (CA, CO, CT, FL, IL, NC, NJ, NM, NY, NV, PA, SD, TX, UT, WA, WI) with VIM-GES-CRPA, a rare strain of extensively drug-resistant P. aeruginosa,” the CDC announced.

An inspection report (pdf) published by the FDA concluded that the manufacturer of EzriCare eye drops, Global Pharma Healthcare, did not follow appropriate protocols to prevent product contamination.

The CDC advises health care providers caring for patients infected with these bacteria to follow the agency’s infection control recommendations to prevent transmission to other patients, as these bacteria have “the potential to spread rapidly in health care settings.”

Death Rate High, but May Not Spread From Person to Person: Expert

In this outbreak, 37 infections were linked to four health care facility clusters.

Three people have died, including one from bloodstream infection. There were also eight reports of vision loss and four reports of surgical removal of an eye, according to the CDC’s report.

Looking back to 2017, multidrug-resistant Pseudomonas aeruginosa caused roughly 32,600 infections among hospitalized patients and nearly 3,000 deaths in the United States.

When asked if the new strain can transfer from person to person outside of a health care facility, Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, said there’s no need to worry for now.

“At this point, it really looks like it is contaminated drops,” she told The Epoch Times. “That’s your incredible risk.”

Nachman explained that if you’re sitting with someone at the kitchen table, you’re not necessarily going to pass the infection.

“It requires a rather very specific route of inoculation to get to the part where you say ‘I have the infection,’” she said, emphasizing that while it’s possible, in this case, it’s unlikely. This is because the bacteria need the right temperature and environment.

“They (Pseudomonas bacteria) need to have something to grow on correctly; you need to have a body part attached to it, so to speak,” she explained.

She gave an example that people could touch their desk and then rub their eyes, but, “Is it possible that you would get enough active bacteria on the desk to my hand, to my eye? It’s possible. Is it likely? No.”

Symptoms of Infection

When you think about how many people have bad environmental allergies, or even a cold or another viral illness right now, your symptoms will all look the same, said Nachman.

“You’ll feel bad, and you’ll have pain, tenderness, and drainage of your eye,” she continued, emphasizing that you need to decide if these are the same symptoms you typically get from allergies or illness, or something different.

“I would say, if you are someone who’s been using any kind of eye drop, and you’re having those symptoms,” Nachman said, “then the answer is, please call your doctor and have it checked out.”

4 Tips to Avoid Infection Through Eye Drops

There are precautions you need to take when using eye drops to reduce infection risk.

1. Follow instructions for use; if they say to throw it out at the end of the month, you should do so. “Because they will get infected with a whole host of bacteria, not just Pseudomonas,” Nachman warned. “So if a medicine says ‘use for a month and discard,’ that’s exactly what you should do.”
2. Wash your hands before applying eye drops so that you’re not contaminating the container, said Nachman.
3. Be aware if there’s a recall, and check your medicine cabinet. If you’ve been using a recalled brand, speak with your doctor and find out if there’s something you need to do.
4. Nachman recommends smelling the eye drops. “If it smells bad, it’s infected; don’t use it, just throw it out,” she advised.

Preventing the Spread of Pseudomonas

Nachman emphasized the importance of isolating those infected in a health care setting, because in that case, it’s not just an eye infection, but also the body at risk.

“Is it in your lungs, is it in your GI tract, are you shedding it in other fluids?” Nachman asked. “Those fluids could then pass it to someone else.”

She explained that a health care setting is “quite different” than your household setting, the first difference being that there are other sick patients, which increases the risk of spreading.

The next difference is if you’re already sick enough to be hospitalized, the amount of resistant bacteria in your body is going to be higher.

In the home, Nachman recommends practicing thorough hand washing, but there’s no need to lock someone in their room.

She pointed out that good handwashing and a good source of infection control is the most important thing.