Health Alert Network (HAN) — Feb. 2, 2023

For more information, please contact:

Jackson County Health Department

Epidemiology Division

[email protected] | (816) 404-9898

Health Advisory: Outbreak of P. aeruginosa Linked to Artificial Tears

Good afternoon —

The Jackson County Health Department’s Communicable Disease Epidemiology Program would like to bring your attention to a recent Health Alert Network (HAN) Official CDC Health Advisory, which notifies clinicians and public health authorities of an outbreak of extensively drug-resistant Pseudomonas aeruginosa associated with artificial tears. 


The full health advisory can be read here. The key points covered in the update are as follows:


  • 55 patients in 12 different states have been diagnosed with a rare strain of extensively drug-resistant P. aeruginosa.
  • CDC laboratory testing has identified the presence of the outbreak strain in opened EzriCare Artificial Tears bottles with different lot numbers collected from two states.
  • Patients and healthcare providers should immediately discontinue using EzriCare artificial tears pending additional guidance from CDC and the Food and Drug Administration.


Recommendations for Healthcare Providers:


  • Immediately discontinue using EzriCare Artificial Tears pending additional guidance from CDC and FDA.
  • Advise patients who used EzriCare Artificial Tears to monitor for signs and symptoms of infection. Perform culture and antimicrobial susceptibility testing when clinically indicated.
  • Healthcare providers treating patients for keratitis or endophthalmitis should ask patients if they have used EzriCare Artificial Tears. Providers should consider performing culture and antimicrobial susceptibility testing to help guide therapy if patients report use of this product.
  • Healthcare providers treating VIM-GES-CRPA infections should consult with a specialist knowledgeable in the treatment of antibiotic-resistant bacteria to determine the best treatment option. VIM-GES-CRPA isolates associated with this outbreak are extensively drug-resistant. Isolates that underwent susceptibility testing at public health laboratories were not susceptible to cefepime, ceftazidime, piperacillin-tazobactam, aztreonam, carbapenems, ceftazidime-avibactam, ceftolozane-tazobactam, fluoroquinolones, polymyxins, amikacin, gentamicin, and tobramycin. A subset of 3 isolates that underwent antimicrobial susceptibility testing for cefiderocol at clinical laboratories or CDC were susceptible to this agent. 
  • Place patients infected or colonized with VIM-GES-CRPA and admitted to acute care settings in isolation and use Contact Precautions. For residents of skilled nursing facilities who are infected or colonized with VIM-GES-CRPA, use Enhanced Barrier Precautions if the resident does not have an indication for Contact Precautions.
  • At this time, CDC does not recommend testing patients who have used this product and who are not experiencing any signs or symptoms of infection.



Categories of Health Alert Network messages:


Health Alert- provides vital, time-sensitive information for a specific incident or situation; warrants immediate action or attention by health officials, laboratorians, clinicians, and members of the public; and conveys the highest level of importance.


Health Advisory- provides important information for a specific incident or situation; contains recommendations or actionable items to be performed by public health officials, laboratorians, and/or clinicians; may not require immediate action.


Health Update- provides updated information regarding an incident or situation; unlikely to require immediate action.


HAN Info Service- provides general public health information; unlikely to require immediate action.


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The Jackson County Health Department’s mission is to offer services, provide programs and advocate for policies so that all people have a fair and just opportunity to be healthy. Find more information about how the health department is fostering a community where all people can live their healthiest lives at