Extensively Drug-Resistant Pseudomonas aeruginosa Outbreak Associated With Artificial Tears

作者：Marissa K. Grossman, Danielle A. Rankin, Meghan Maloney, Richard A. Stanton, Paige Gable, Valerie Stevens, Thomas O. Ewing, Katharine Saunders, Sarah J. Kogut, Elizabeth J. Nazarian, Sandeep K. Bhaurla, Jehan Mephors, Joshua Mongillo, Susan Stonehocker, Jeanette Prignano, Nickolas Valencia, Argentina Charles, Kiara McNamara, William A Fritsch, Shannon B. Ruelle, Carrie Ann Plucinski, Lynn E. Sosa, Belinda E. Ostrowsky, David Cal Ham, Maroya Spalding Walters, for the Multistate Pseudomonas Outbreak Investigation Group, Homero Aguilar, Amir Hossein Alavi, Rocío Balbuena, Jasna Braut-Taormina, Hollianne Bruce, Wiley Chambers, Kai-Shun Chen, Kristen Clancy, M. Cockrell, Karlos Crayton, Michael Cyrus, Marisa D’Angeli, Maria Carmen G. Diaz, Jan Ryan Dollete, Samuel Eskenazi, Lorene Fong, Rosalie Giardina, Jennifer M. Gogley, William G. Greendyke, Susan Hadman, Hollis Houston, Catherine Huck, Philip F Istafanos, Amber Jean-Louis, Deborah Lynne Jones, M Kratz, Thao Kwan, Sammie P. La, Susan E. Lance, Megan Lasure, Cynthia Longo, Maria Machado, Gillian A. McAllister, Sherri McGarry, Susannah L. McKay, Derek L Miller, M. Musk, Kelsey OYong, Elvis Patel, Arthur Pightling, Allison Rodriguez, Jeffery Rogers, H Romero, Mona Satyam, Matthew Silverman, Gail Skolek, Amanda J Smith, Anna L. Stahl, Luis Torres, Kavita K. Trivedi, N. Wilmott · 发表于：Clinical Infectious Diseases · 年份：2024 · DOI：10.1093/cid/ciae052 · 被引用次数：38 · 研究领域：Antibiotic Resistance in Bacteria、Ocular Infections and Treatments、Bacterial Identification and Susceptibility Testing

BACKGROUND: Carbapenemase-producing, carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) are extensively drug-resistant bacteria. We investigated the source of a multistate CP-CRPA outbreak. METHODS: Cases were defined as a US patient's first isolation of P. aeruginosa sequence type 1203 with carbapenemase gene blaVIM-80 and cephalosporinase gene blaGES-9 from any specimen source collected and reported to the Centers for Disease Control and Prevention during 1 January 2022-15 May 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. RESULTS: 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 4 (22%) of 18 with eye infections underwent enucleation. In the case-control study, case-patients had increased odds of receiving artificial tears versus 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. Food and Drug Administratio...