The deadly bacteria linked to recalled eyedrops causing infection and blindness had never been seen in the U.S. until 2022, according to the Centers for Disease Control and Prevention. It has since infected dozens or people and killed three. Even though the contaminated bottles have been removed from stores and health care facilities, the CDC expects more cases to be identified.
What has infectious disease experts most alarmed is how this bug — a well-known type of bacterium, Pseudomonas aeruginosa — has evolved in a way that is resistant to nearly all available treatments.
As of Friday, the CDC had identified 68 cases of a new strain of Pseudomonas aeruginosa in 16 states. The investigation is still underway, and the agency has to wait for states to report other cases.
More than half of the cases have been found in long-term health care facilities. Nearly all are linked to contaminated eyedrops that had been imported from India.
Pseudomonas aeruginosa has been around for years. In 2020, there were an estimated 28,800 drug-resistant cases in hospitals in the U.S., a CDC investigator not authorized to speak to the media said.
But the new infections revealed a form that had never before been reported in the U.S.: carbapenem-resistant Pseudomonas aeruginosa with Verona integron-mediated metallo-β-lactamase and Guiana extended-spectrum-β-lactamase.
The long name basically shows how its genes have transformed to make it more drug-resistant over time.
“This was a Pseudomonas original,” Dr. Robert Bonomo, a professor of medicine at Case Western Reserve University in Cleveland who has studied a variety of drug-resistant bacteria since 1990, said in an interview.
The CDC’s investigation revealed that the infections linked to the eyedrops may be treated by only one known antibiotic, called cefiderocol.
There’s nothing new about the way the mutated bacteria harm the body. It’s the drug resistance that makes them so dangerous.
Eye infections have been most common. But because the eyes are directly linked to the nasal cavity, the bacteria can move into the respiratory tract and lead to pneumonia.
“Pseudomonas aeruginosa can affect pretty much any tissue in the body as travels through the blood, and it can cause sepsis,” said Dr. Guillermo Amescua, a cornea specialist at the Bascom Palmer Eye Institute of the University of Miami Miller School of Medicine.
Amescua’s team has treated seven patients.
The Connecticut Department of Public Health investigated its first case in June. Since then, a department spokesman said, it has identified 26 patients. Most have been in long-term health care facilities.

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