Drug-resistant bacteria linked to eye drops can spread from person to person

The C.D.C. attributed deaths and cases of blindness to products imported from India. The agency said it was concerned the bacteria could take hold in the United States. to a person at a Connecticut long-term care center has raised concerns that the strain is taking hold in US health care facilities, according to the Centers for Disease Control and Prevention.

Infectious disease specialists said the strain had not previously been detected in the United States and was particularly difficult to treat with existing antibiotics.

In recent months, three deaths, eight cases of blindness and dozens of infections have been attributed to EzriCare artificial tears, according to the C.D.C., leading to a widespread recall this year.

The Food and Drug Administration, which regulates over-the-counter drugs, has stopped imports of the product. But these outbreaks highlight regulatory gaps in controlling overseas drug imports.

The F.D.A. confirmed that it had not inspected the factory where the eye drops were made in India before the infections were reported, but that the agency had since visited the factory, which is operated by Global Pharma Healthcare.

The agency has long been criticized for shortcomings in overseas manufacturing inspections in China and India, which are the two main producers of drugs and raw ingredients for medicines. Other cases of contaminated products from overseas included blood pressure medication suspected of containing a possible carcinogen and lethal batches of heparin, both of which prompted mass recalls.

The F.D.A. said he continues to work with the C.D.C. and had urged retailers to ensure products were removed from shelves.

In the latest case, eye drops are linked to even tougher bacteria to drugs that a product similar to bacteria that the C.D.C. tends to see in about 150 cases a year, mostly in intensive care settings, according to Maroya Walters, principal investigator of the CDC's Antimicrobial Resistance Team

dr. Walters said the spread of the new strain "could really change the outlook".

The bacteria showed signs of spreading in central Connecticut in asymptomatic patients who had the bacteria colonized in their body. Such spread tends to occur when patients touch common objects or when healthcare workers pass the germs on.

The eye drop-related bacteria, Pseudomonas aeruginosa resistant to drugs, is already a major concern for healthcare providers, especially among those with compromised immune systems, nursing home residents, and patients with invasive medical devices like catheters and breathing tubes. /p>

Dr. David van Duin, an infectious disease specialist at the University of North Carolina School of Medicine, said resistant pseudomonads were particularly difficult to eradicate, both from healthcare settings, where they cling tenaciously to sinks, water taps and other moist environments, and patients who develop bloodstream infections.

"It's very hard to get rid of it", he said.

By now, cases associated with eye drops have been largely contained, thanks to a product recall and widespread attention from media, Dr. Walters said. The F.D.A. also announced the recall of Delsam Pharma's artificial eye ointment, made in the same factory as eye drops, due to possible contamination.

The C.D.C. asks physicians to work with public health labs to determine the genetic fingerprint of hard-to-treat Pseudomonas infections in the eyes and throughout the body.

"I think we're gonna see the impact of this game over the course of months if not years,” Dr. Walters said.