Details

Autor(en) / Beteiligte

• Grossman, Marissa K
• Rankin, Danielle A
• Maloney, Meghan
• Stanton, Richard A
• Gable, Paige
• Stevens, Valerie A
• Ewing, Thomas
• Saunders, Katharine
• Kogut, Sarah
• Nazarian, Elizabeth
• Bhaurla, Sandeep
• Mephors, Jehan
• Mongillo, Joshua
• Stonehocker, Susan
• Prignano, Jeanette
• Valencia, Nickolas
• Charles, Argentina
• McNamara, Kiara
• Fritsch, William A
• Ruelle, Shannon
• Plucinski, Carrie Ann
• Sosa, Lynn
• Ostrowsky, Belinda
• Ham, D Cal
• Walters, Maroya S

Titel

Extensively Drug-Resistant Pseudomonas aeruginosa Outbreak associated with Artificial Tears

Ist Teil von

• Clinical infectious diseases, 2024-07, Vol.79 (1), p.6-14

Ort / Verlag

United States

Erscheinungsjahr

2024

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Carbapenemase-producing, carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) are extensively drug resistant bacteria. We investigated the source of a multistate CP-CRPA outbreak. Cases were defined as a U.S. patient's first isolation of P. aeruginosa sequence type 1203 with the carbapenemase gene blaVIM-80 and cephalosporinase gene blaGES-9 from any specimen source collected and reported to CDC between January 1, 2022-May 15, 2023. We conducted a 1:1 matched case-control study at the post-acute care facility with the most cases, assessed exposures associated with case status for all case-patients, and tested products for bacterial contamination. We identified 81 case-patients from 18 states, 27 of whom were identified through surveillance cultures. Four (7%) of 54 case-patients with clinical cultures died within 30 days of culture collection, and four (22%) of 18 with eye infections underwent enucleation. In the case-control study, case-patients had increased odds of receiving artificial tears compared to controls (crude matched OR: 5.0, 95% CI: 1.1, 22.8). Overall, artificial tears use was reported by 61 (87%) of 70 case-patients with information; 43 (77%) of 56 case-patients with brand information reported use of Brand A, an imported, preservative-free, over-the-counter (OTC) product. Bacteria isolated from opened and unopened bottles of Brand A were genetically related to patient isolates. FDA inspection of the manufacturing plant identified likely sources of contamination. A manufactured medical product serving as the vehicle for carbapenemase-producing organisms is unprecedented in the U.S. The clinical impacts from this outbreak underscore the need for improved requirements for U.S. OTC product importers.