Outbreak of Extensively Drug-resistant Pseudomonas aeruginosa Associated with EzriCare Artificial Tears
The Centers for Disease Control and Prevention (CDC) issued a Health Advisory to inform patients and clinicians of potential contamination of EzriCare Artificial Tears with a rare strain of extensively drug-resistant P. aeruginosa.
The strain of P. aeruginosa is referred to as VIM-GES-CRPA, which stands for: Verona Integron-mediated Metallo-?- lactamase (VIM) and Guiana-Extended Spectrum-?-Lactamase (GES)-producing carbapenem-resistant Pseudomonas aeruginosa.
55 cases of infection have been reported in 12 states (CA, CO, CT, FL, NJ, NM, NY, NV, TX, UT, WA, WI)
Recommendations for Healthcare Providers
- Immediately discontinue using EzriCare Artificial Tears pending additional guidance from CDC and FDA.
- Advise patients who used EzriCare Artificial Tears to monitor for signs and symptoms of infection. Perform culture and antimicrobial susceptibility testing when clinically indicated.
- Healthcare providers treating patients for keratitis or endophthalmitis should ask patients if they have used EzriCare Artificial Tears. Providers should consider performing culture and antimicrobial susceptibility testing to help guide therapy if patients report use of this product.
- Healthcare providers treating VIM-GES-CRPA infections should consult with a specialist knowledgeable in the treatment of antibiotic-resistant bacteria to determine the best treatment option. VIM-GES-CRPA isolates associated with this outbreak are extensively drug-resistant. Isolates that underwent susceptibility testing at public health laboratories were not susceptible to cefepime, ceftazidime, piperacillin-tazobactam, aztreonam, carbapenems, ceftazidime-avibactam, ceftolozane-tazobactam, polymyxins, amikacin, gentamicin, and tobramycin. A subset of 3 isolates that underwent antimicrobial susceptibility testing for cefiderocol at clinical laboratories or CDC were susceptible to this agent.
- Place patients infected or colonized with VIM-GES-CRPA and admitted to acute care settings in isolation and use Contact Precautions . For residents of skilled nursing facilities who are infected or colonized with VIM-GES-CRPA, use Enhanced Barrier Precautions if the resident does not have an indication for Contact Precautions.
- At this time, CDC does not recommend testing patients who have used this product and who are not experiencing any signs or symptoms of infection.
Please report any carbapenem-resistant Pseudomonas aeruginosa (CRPA) from an ocular specimen or VIM-CRPA from any specimen source with collection dates since January 1, 2022, to your local or state health department's healthcare-associated infections contact or email email@example.com for assistance submitting specimens. Ask your clinical laboratories to save these isolates for further characterization at public health laboratories.
For more information download the official CDC Health Avisory