The dangers of eye drops hidden in the medicine cabinet

Dangerous eye infection illustration

In February 2023, the CDC warned against using Ezricare eye drops because of its association with drug-resistant bacterial infections that cause vision loss and death. A multidisciplinary group of researchers and physicians in Cleveland, Ohio, published a November 2022 case study detailing a corneal ulcer in a 72-year-old female patient caused by this bacterium. Pseudomonas aeruginosa. The patient’s contaminated eye drops were identified as the source of infection and were treated with strong antibiotics. Since the CDC’s warning, Pseudomonas aeruginosa Although this product has been removed from stores, it may still pose a risk to those who keep it in their medicine cabinet.

The CDC has warned against using Ezrikere eye drops because they have been linked to drug-resistant infections, vision loss, and death. Researchers now detail a case of corneal ulcers caused by Pseudomonas aeruginosa, which they were able to trace to contaminated eye drops. Product has been removed from store shelves, but risks may still exist.

  • Pseudomonas aeruginosa It is a pathogenic, drug-resistant Gram-negative bacterium
  • CDC advises against using some artificial tears eye drops contaminated with microbes
  • In November 2022, doctors in Cleveland diagnosed a patient with corneal ulcers with the following symptoms: P. Pseudomonas aeruginosa infection
  • Patient contracted infection from contaminated eye drops months before CDC’s February 2023 warning

In February 2023, the Centers for Disease Control and Prevention warned people against using Ezricare eye drops, saying a bottle of the product was linked to drug-resistant bacterial infections that lead to blindness and death. But long before that, contaminated bottles were causing problems.

in last week’s diary Antibiotics and chemotherapyThe researchers, an interdisciplinary group of researchers and doctors in Cleveland, Ohio, are reporting on the November 2022 case. The patient was a 72-year-old woman diagnosed with a corneal ulcer caused by a bacterial infection. Pseudomonas aeruginosa. Eventually, an infectious disease doctor and microbiologist identified her contaminated eye drops as the source of the infection.

Pseudomonas aeruginosa It is a pathogenic Gram-negative bacterium that is resistant to treatment with most antibiotics. It can cause swimmer’s ear, a painful infection of the ear canal, and more serious conditions, especially in people with a weakened immune system. But the Cleveland case was unusual, said Morgan Morelli, M.D., Ph.D., lead author of the study and an infectious disease researcher at the hospital.

“I never recovered it from my eyes,” she said.because Pseudomonas aeruginosa It’s not usually seen with eye infections, she said, making it difficult to find the correct diagnosis. “It took a lot of thinking and digging to figure out what was going on,” she said. “And I had no idea it was related to global manufacturing problems.”

The patient initially presented to an outpatient eye clinic with blurred vision. From there she was sent to the hospital’s emergency department, where she was seen by an ophthalmologist. They cultured her infection, prescribed her multiple high-potency antibiotic eye drops, and sent her home. However, the next day her eye condition worsened and she visited a corneal specialist.

The patient noticed a yellow discharge on her pillow, but she was not swimming. “She wondered if she accidentally touched something or maybe there was some kind of accident,” Morelli said as an explanation for her infection.

At that point, Morelli said her case was referred to the hospital’s microbiologist and infectious disease specialist. Infectious disease specialist Dr. Scott Fulton asked her patient’s husband to bring eye drops for her examination. Patient samples were sent to the lab of Dr. Robert Bonomo, an expert in Gram-negative and drug-resistant bacteria at Case Western Reserve University School of Medicine.

And Morelli said the pieces came together. Dr. Bonomo’s laboratory Pseudomonas aeruginosa It was an isolate that matched the genetic material in the Ezrikea artificial tears eye drops she was using. The researchers then linked the contaminated water droplets to eye infections and the ulcers they caused.

Treatment was extremely difficult, Morelli said. This isolate was resistant to any antibiotic that could be administered through the patient’s eye. Instead, she was treated with cefiderocol, a potent antibiotic that has some activity against gram-negative bacteria, and two other topical antibiotics. Morelli said her eye damage had improved, but it was unclear if the patient would be able to regain full vision.

Since issuing the alert in February, the CDC has identified cases of infection due to: Pseudomonas aeruginosa Spring 2022 at the earliest. “In terms of what all of these patients have in common, I think it took a while to get this issue together,” Morelli said. The contaminated product has been removed from stores and is no longer available for purchase, but it may still pose a risk.

People may still have it in their medicine cabinet, Morelli said. She also hopes ophthalmologists and optometrists who may be the first to see patients with the infection in the future will know what to look for. “We don’t always ask for this detailed medical history or ask people to bring over-the-counter medications they’re using,” she says. “We really wanted to raise awareness.”

Reference: “Investigation and treatment of corneal ulcers due to advanced drug resistance” Pseudomonas aeruginosaMorgan K. Morelli, Amy Klusterbohr, Scott A. Fulton, Jennifer Hullin, Nicholas Newman, Ahmed F. Omar, Laura J. Rojas, Stephen H. Marshall, Mohammad Yasmin, Robert By A. Bonomo, May 11, 2023, Antibiotics and chemotherapy.
DOI: 10.1128/aac.00277-23

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