Contaminated Eye Drops Outbreak; Bacteriophages maybe the Solution

CDC: Contaminated Eye Drops Outbreak Has Left 3 Dead, 4 With Eyeballs Removed
The Pseudomonas aeruginosa outbreak linked to artificial tears has continued on its tear, so to speak. This is the outbreak that I first covered for Forbes back on February 2and involves an extensively drug resistant (XDR) version of the bacteria. Well, on March 21, the Centers for Disease Control and Prevention (CDC) provided a new update on this “eye caramba” situation. As of March 14, this outbreak has left at least 68 people infected across 16 states. These infections have resulted in three people dying, eight losing their vision, and four having had their eyeballs surgically removed. Such outcomes obviously are not good to see. Typically, you don’t say, “So, your day was uneventful,” after someone mentions getting their eyeballs removed. The same applies to deaths.
The official name of the bacteria causing this outbreak is Verona integron-mediated metallo-β-lactamase and Guiana extended-spectrum-β-lactamase carbapenem-resistant P. aeruginosa. That’s quite a mouthful. So, if you happen to have limited time, you can call the bacteria VIM-GES-CRPA or XDR P. aeruginosa for short. All of those words before the P. aeruginosa doesn’t mean that the bacteria was married multiple times. Rather those words describe the different enzymes that this version of the bacteria has acquired to break down various antibiotics so that they can’t harm the bacteria.
P. aeruginosa isn’t like love. You don’t want it in your eyes. In fact, you don’t want it in other parts of your body either such as your respiratory tract, urinary tract, your skin, or your bloodstream. This dirty bacteria that’s often found in soil and water can cause some bad infections in different parts of your body. Once it gets inside you in any way, it can subsequently spread to other parts of your body as well, which isn’t swell. From May 2022 through February 2023, doctors have found this XDR P. aeruginosa in sputum, bronchial wash, cornea, urine, blood, and rectal swab samples from the patients affected by the outbreak.
Most of the affected patients have indicated that they had used artificial tears eye drops. While in total they have used over 10 different brands of artificial tears, the most commonly used brand was EzriCare Artificial Tears. Laboratory testing by CDC did find VIM-GES-CRPA in EzriCare bottles that had been opened and used by both those with eye infections and those without from two different states. Moreover, the U.S. Food and Drug Administration (FDA) did find Global Pharma Healthcare Private Limited, which manufactures EzriCare Artificial Tears, to have violated current good manufacturing practices (CGMP). For example, the company failed to maintain appropriate microbial testing and proper packaging procedures. It’s clearly a bad thing when a company doesn’t keep up proper safety precautions.
San Diego researchers find potential breakthrough to deadly bacteria linked to recalled eye drops
3 people have died, 8 others have gone blind
LA JOLLA, Calif. — Researchers at the University of California San Diego’s School of Medicine believe they’ve found a potential cure to a deadly type of bacteria that’s been linked to recalled eye drops.
A couple of weeks ago the CDC got in touch with researchers at the Center for Innovative Phage Applications and Therapeutics at UCSD.
The center has been working for the past five years to use bacteriophages to treat infections that antibiotics can’t kill.
“What it means literally is bacteria eater,” said Robert Schooley, professor of medicine in diseases at the university, while describing what bacteriophages are.
Researchers say they were able to find a few phages that were able to kill the bacteria in the samples sent by the CDC. But they won’t know for sure if it’s a breakthrough until it’s been used successfully on a patient.
“We don’t know whether all of the strains will be exactly the same strain or whether they will all be sensitive the same phage. But we think there’s a good chance that many of them, if not all of them will have at least one phage that will be active against the organism that has been causing this problem,” Schooley said.
The CDC said in an update Tuesday that three people had died and eight others had gone blind after using artificial tears. Four people have had their eyeballs surgically removed.
So far at least 68 people in 16 states including California have developed pseudomonas aeruginosa. It is an extremely drug-resistant strain of bacterium that has caused multiple types of infections including to the eye.
The CDC says eye drops were common exposure for many patients and is advising Americans to stop using EzriCare or Delsam Pharma’s Artificial Tears products.
“Patients reported over 10 different brands of artificial tears and some patients used multiple brands. EzriCare Artificial Tears, a preservative-free, over-the-counter product packaged in multidose bottles, was the brand most commonly reported,” the CDC said in an update online.
FDA approval required
The director of microbiology at UCSD said researchers could have the phages, a potential cure, available to infected patients on an emergency case by case basis in as little as week but stressed it would require approval from the FDA first.
“In some ways you could think of it as a breakthrough. Another more simple way of thinking about it is this is nature. What we have found in terms of these bacteriophages are naturally occurring,” said David Pride in an interview with ABC 10News at the lab with the CDC samples.
Schooley said the potential cure could be given to patients through an eye dropper, a needle to the surface of the eye or by inserting fluid inside the eye.
The researchers believe the phages could be used more widely to treat other infections in the future that antibiotics won’t kill.
“We are running up against a wall with developing traditional antibiotics. And we need new approaches, millions of people are going to be dying of multidrug resistant bacteria. We’re already losing about a million a year worldwide,” said Schooley.