Drug-resistant bacteria, linked to Indian eye drops, can spread person to person: Report

A highly drug-resistant bacteria that was linked to eye drops imported from India can spread from person to person, The New York Times reported on Monday.

On March 21, America's top health agency - Centers for Disease Control and Prevention or CDC - said it was probing a multi-state outbreak of an extensively drug-resistant strain of Pseudomonas aeruginosa - a type of germ that can cause infections in humans.

As of March 14, the CDC identified 68 patients in 16 states with the rare strain of drug-resistant bacteria. Of these infected, three people died and eight people reported vision loss. As per the health agency, most patients reported using artificial tears - some of them imported from India.

Also read - Chennai-based Global Pharma recalls 50,000 tubes of contaminated eye drops in US: Report

"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 its report on March 21.

EzriCare Artificial Tears is manufactured by Chennai-based Global Pharma Healthcare, which has now recalled 50,000 tubes of its eye drops in the US market.

On February 2, US drug regulatory agency - Food and Drug Administration or FDA - warned consumers and health care practitioners not to purchase and to immediately stop using EzriCare or Delsam Pharma's Artificial Tears due to potential bacterial contamination. It said using contaminated artificial tears increased the risk of eye infections that could result in blindness or death.  

NYT on Monday reported that in the latest cases, the eye drops are linked to bacteria that is even more drug-resistant than a similar bacteria that the CDC tends to see in about 150 cases per year.

Maroya Walters, the lead investigator for the CDC's antimicrobial resistance team, told the daily that the spread of the newest strain "could really change the outlook for that". The bacteria showed signs of spreading among asymptomatic patients in Connecticut who had the bacteria colonised in their bodies, the report said, adding that such spread tends to occur when patients touch common items or when healthcare workers transmit the germs.

Dr David van Duin, an infectious disease specialist at the University of North Carolina School of Medicine, told NYT that resistant bacteria were especially difficult to eradicate, both from healthcare facilities and from patients who develop bloodstream infections. "It's very hard to get rid of," he was quoted as saying.

The FDA has not said how much of the product made by Global Pharma Healthcare was imported to the US. However, the report said, the supply chain research unit of S&P Global Market Intelligence, showed that Global Pharma sent US distributors four shipments in 2021 and 2022 amounting to tens of thousands of half-ounce bottles of EzriCare artificial tears.

In an update on February 2, the US drug regulator said Global Pharma had initiated a voluntary recall at the consumer level of all unexpired lots of EzriCare Artificial Tears and Delsam Pharma's artificial tears. 

The FDA had recommended this recall due to "the company's current good manufacturing practice (CGMP) violations, including lack of appropriate microbial testing, formulation issues (the company manufactures and distributes ophthalmic drugs in multi-use bottles, without an adequate preservative), and lack of proper controls concerning tamper-evident packaging".