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Death toll rises in artificial tears recall

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The Centers for Disease Control and Prevention (CDC) announced that, as of March 14, 2023, two more deaths have been reported and the number of infection cases and states have risen due to the outbreak of an extensively drug-resistant bacteria associated with the previously recalled EzriCare Artificial Tears.

I need some background.

The CDC announced in January 2023 that it was investigating an outbreak of cases of Verona Integron‐mediated Metallo‐β‐lactamase (VIM)‐ and Guiana‐Extended Spectrum‐β‐Lactamase (GES)‐ producing carbapenem‐resistant Pseudomonas aeruginosa (VIM‐GES‐CRPA) in clusters within multiple states that were linked to various infection sites (inclusive of ocular tissues).

The outbreak is connected to the use of 10 different brands of over-the-counter (OTC) artificial tears, with EzriCare Artificial Tears being the most commonly-reported brand used by consumers.

The CDC originally issued a voluntary recall for EzriCare, which was then escalated to Health Alert Network (HAN) Advisory in February 2023  that mandated all eye care practitioners (ECPs) and patients immediately stop use of the eye drops.

Also of note, a recall was issued for Delsam Pharma’s artificial tears.

See more details here and here.

What’s the latest update on this?

The CDC confirmed that two more patient deaths were reported among those infected by the VIM-GES-CRPA bacteria (for a total of three deaths).

Further, out of the 68 patient cases across 16 states, there have been eight reports of vision loss and four reports of enucleation (surgical removal of an eyeball).

What other symptoms have patients reported?

The CDC indicated that additional eye infection symptoms may include:

  • Yellow, green, or clear discharge from the eye
  • Eye pain or discomfort
  • Redness of the eye or eyelid
  • Foreign body sensation within the eye
  • Increased light sensitivity
  • Blurry vision

Anything else to know?

The CDC also announced that researchers from University of California, San Diego have identified a bacteriophage that may potentially treat the bacteria, which is known to be extensively drug-resistant.

Previous research from the university’s Center for Innovative Phage Applications and Therapeutics includes the development of “phage” therapies to treat patients with infections caused by drug-resistant bacteria.

According to the CDC, no infected patients have been treated with this therapy as of the time of this report.

So what is the CDC recommending?

The CDC stated that any clinicians and patients should immediately stop using EzriCare Artificial Tears pending additional guidance from the CDC and FDA.