What to Know About Bacteria and Eye Drops

The Centers for Disease Control and Prevention has warned people to stop using “artificial tear” eye drops sold by EzriCare or Delsam Pharma, noting that an “extensively” antibiotic-resistant Pseudomonas aeruginosa bacteria has been found in multiple open containers of the drops. Officials investigating the outbreak have also seen signs of a spread beyond those who used the drops to others in the same health care center. The products have been subject to a nationwide recall.

Here’s what doctors want people to know.

If I used those eye drops, what symptoms should I look for?

The C.D.C. said eye infections may include yellow, green or clear discharge from the eye, pain or discomfort, redness, increased sensitivity to light and blurry vision. Patients who used the drops and developed other illnesses, like respiratory or urinary tract infections, should tell their doctor they used the drops, said Maroya Walters, lead investigator for the C.D.C.’s antimicrobial resistance team.

What’s the best way to avoid infection from contaminated eye drops?

Eye drop bottles can become tainted by bacteria once opened, but there are easy ways to avoid contamination, according to Patricia Jackson, president of the Association for Professionals in Infection Control and Epidemiology. If possible, she said, always select eyedrops that contain preservatives, which inhibit the growth of bacteria.

Wash your hands before using drops, never use expired products and be careful not to touch the tip of the bottle to your eye or eyelashes, she said. Once a sealed bottle has been opened, it should be thrown away within a month. And never share eye drops with other people.

A scanning electron microscope image of the rod-shaped Pseudomonas aeruginosa bacteria.Credit…Janice Haney Carr/CDC, via Associated Press

How else can it spread?

Pseudomonas aeruginosa can be spread through hands, water or medical instruments. But in health care settings, patients with intravenous ports, catheters or breathing tubes are most at risk because pathogens can more easily find their way directly into the body, by bypassing the protection afforded by the skin.

Should I be worried about other types of eye drops?

Dr. Vicente Diaz, an ophthalmologist and infectious disease specialist at Yale Health, said people should continue to use other types of eye drops as prescribed or other over-the-counter products from trusted brands.

I don’t use eye drops. Am I still at risk for becoming infected?

Pseudomonas aeruginosa is a ubiquitous bacteria found in soil and water, and can colonize on human skin, but the bacteria pose little threat to most people, said Dr. David van Duin, director of the immunocompromised host infectious diseases section at the University of North Carolina School of Medicine.

Those most at risk are hospitalized patients with weakened immune systems, recovering burn patients, people with cystic fibrosis and anyone with invasive medical devices.

For Dr. van Duin, the larger takeaway is to limit the use of antimicrobial drugs to ensure they remain effective. Antibiotics can kill good bacteria in the gut, leaving people vulnerable to drug-resistant pathogens.

Overuse of antibiotics can encourage the targeted bacteria to mutate, rendering them immune to existing medication. “If we want to address the problem of antibiotic resistance, the best thing people can do is to take antibiotics only when necessary,” he said.

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