CDC Update Identifies Fourth Death Linked to Eyedrop Recall

On May 19, 2023, the CDC released an update on the Pseudomonas aeruginosa outbreak linked to artificial tears from Global Pharma Healthcare. The report identifies a fourth death linked to the series of eye drop recalls.

Beyond an additional death, the organization revealed that, as of May 15, 2023, there were 81 reported infections with drug-resistant P. Aeruginosa, VIM-GES-CRPA, across 18 states, including California, Colorado, Connecticut, Delaware, Florida, Illinois, North Carolina, Nevada, New York, Ohio, Pennsylvania, South Dakota, Texas, Utah, Washington, and Wisconsin.

Compared to the most recent update, an additional 13 patients were identified; however, roughly 46% of the samples collected from these patients were before the initial recall. The remaining seven patients identified in this update reported using a recalled eyedrop brand or were in a care facility with other reported cases.

The report also indicated the sample collection methods, stating that, across all reported cases, 14 were identified from sputum cultures, bronchial washes, or tracheal aspirate. Other forms of specimen collection included cultures of a site near the eye, urine samples, cultures of other nonsterile sources, blood, ear samples, and rectal swabs.

Roughly 14 patients reported vision loss linked to this infection and eyedrop use. An additional four patients had an enucleation — surgical removal of the eyeball. Finally, four deaths within 30 days of sample collection were reported.

While infected individuals used ten different eyedrops, the EzriCare Artificial Tears manufactured by Global Pharma Healthcare were the most used eyedrops. Based on laboratory testing by the CDC, multiple bottles of EzriCare were contaminated with P. Aeruginosa regardless of whether or not the user was infected. Additionally, unopened bottles also were contaminated.

According to the CDC statement and FDA recalls, the following products have been recalled and should be avoided by all patients: EzriCare Artificial Tears, Delsam Pharma Artificial Tears, and Delsam Pharma Artificial Ointment. Patients who have used these products and are experiencing any of the following symptoms should seek help from a licensed healthcare provider:

• Ocular discharge
• Ocular pain or discomfort
• Eye or eyelid redness
• Foreign body sensation
• Sensitivity to light
• Blurry vision

As the flurry of eyedrop recalls progresses and public health organizations continue to investigate, providers and patients must remain vigilant about the risks of over-the-counter eyedrops. Meanwhile, pharmaceutical companies and regulatory organizations ought to find ways to minimize contamination risk and ensure patient safety.