CDC Investigating Artificial Tears Product Linked to Drug-Resistant Infections

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The Centers for Disease Control and Prevention (CDC) is urging health care providers and patients to immediately discontinue use of EzriCare Artificial Tears as the Agency is currently investigating its link to multiple different infection types, including eye infections.

From May 17, 2022 to January 19, 2023, the CDC, alongside state and local health departments, has identified 56 isolates from 50 case patients across 11 states with Verona Integron‐mediated Metallo‐β‐lactamase (VIM)‐ and Guiana‐Extended Spectrum‐β‐Lactamase (GES)‐ producing carbapenem‐resistant Pseudomonas aeruginosa (VIM‐GES‐CRPA). These isolates were identified from clinical cultures of the cornea (10), sputum or bronchial wash (11), urine (6), other nonsterile sources (4), blood (2), and rectal swabs (23) collected for surveillance.

Among these cases, permanent vision loss resulting from ocular infection, hospitalization, and death (1 patient with bloodstream infection) have been reported. In addition to being resistant to carbapenems, the isolates in this cluster have been found to be resistant to ceftazidime and cefepime.

A review of common exposure showed that a majority of these individuals used artificial tears prior to identifying the VIM-GES-CRPA infection. The most common brand reported was EzriCare Artificial Tears, a preservative-free product dispensed in multidose bottles. Testing of opened EzriCare bottles revealed the presence of VIM‐CRPA. The CDC is continuing to test to see if the outbreak strain is present in unopened bottles.

According to a statement from EzriCare, the Company has not received consumer complaints or adverse event reports related to this investigation to date. Moreover, it has not been asked to conduct a recall or received communication from any regulatory agency providing any outcomes or details regarding the ongoing investigation.


Update: multistate cluster of VIM- and GES-producing carbapenem-resistant Pseudomonas aeruginosa associated with Artificial Tears. News release. Centers for Disease Control and Prevention. Accessed February 1, 2023.