Two more people have died and more details are emerging about horrific eye infections a nationwide outbreak To remembered eye drops from EzriCare and Delsam.
The death toll is now three an outbreak update this week from the Centers for Disease Control and Prevention. A total of 68 people in 16 states have contracted a rare, largely drug-resistant drug Pseudomonas aeruginosa Exposure related to the eye drops. In addition to the deaths, eight people have reported vision loss and four have had their eyeballs surgically removed (enucleation).
In a case report Published this week in JAMA Ophthalmology, ophthalmologists at the Bascom Palmer Eye Institute, part of the University of Miami Health System, reported details of a case related to the outbreak — a case in a 72-year-old man suffering from an ongoing infection in his right eye with vision loss, despite weeks of treatment with multiple antibiotics. When the man was first treated, he reported pain in his right eye, which could only see movement at that point, while his left eye had 20/20 vision. Doctors found that the whites of his right eye were completely red and white blood cells had visibly pooled on his cornea and in the anterior inner chamber of his eye.
The man’s eye tested positive for a P. aeruginosa strain resistant to several antibiotics – as was the bottle of EzriCare artificial tear drops he had been using. After further testing, doctors adjusted the man’s treatment schedule to hourly doses of antibiotics, to which the bacterial strain was least resistant. At a follow-up examination after one month, the redness and ocular infiltrates in the man’s eye had improved. But to this day, the infection persists, doctors reported, as does his vision loss. (Graphic images of his right eye at initial presentation and at one month’s follow-up are available Here.)
Growing outbreak
The CDC identified the outbreak strain as VIM-GES-CRPA, which stands for carbapenem-resistant P. aeruginosa (CRPA) with Verona integrin-mediated metallo-β-lactamase (VIM) and Guiana extended-spectrum β-lactamase (GES). This is a largely drug-resistant strain that had never been seen in the US before the outbreak. CDC officials worry the outbreak will cause these types of infections to become more common because the bacteria can colonize asymptomatically in people, spread to others, and share their resistance genes.
Authorities believe the outbreak strain was brought into the country in the contaminated eye drops made by Global Pharma, a Chennai, India-based manufacturer. The Food and Drug Administration reports that she had a series of manufacturing defects. The eye drops were imported into the country by Aru Pharma Inc. and then branded and sold by EzriCare and Delsam Pharma. The products were available nationwide through Amazon, Walmart, eBay and other retailers.
ABC News on Thursday reported another case being treated by doctors at the Bascom Palmer Eye Institute A 68-year-old Miami woman lost an eye after using EzriCare drops. The woman, Clara Oliva, developed an infection in her right eye last August and went to the emergency room at the institute because of severe pain that felt like broken glass in her eye. The doctors discovered that the pain was due to a P. aeruginosa infection, but did not immediately associate it with the eye drops. Doctors attempted to surgically repair the eye, but found extensive, irreparable damage and feared the drug-resistant infection would spread. On September 1st, they completely removed her infected eye. Oliva, who was legally blind from the enucleation and poor vision in her remaining eye, continued using EzriCare eye drops until January, when the CDC issued its first advisory about the outbreak. She is now suing EzriCare, Global Pharma, the medical center that prescribed the eye drops, and her insurer.
Oliva isn’t the only one filing lawsuits. Last month, Jory Lange, a Houston-based attorney with expertise in food safety, filed two lawsuits on behalf of women affected by the outbreak.
“I think unfortunately this outbreak is likely to continue to increase,” Lange told Ars. For one thing, people continue to be diagnosed, he said. However, the CDC has also advised clinicians to look into infections since early last year. As of now, the outbreak’s identified cases span May 2022 to February 2023, but the CDC advises clinicians to report all drug resistance P. aeruginosa Cases as early as January 2022. “We’ve spoken to some people who became infected in this early period, so we think their cases will be added,” Lange said.
