Following Infection Outbreak, Experts Offer Guidance on Safe Use of Eyedrops
MONDAY, March 6, 2023 (HealthDay News) -- An outbreak of serious bacterial infections in 13 U.S. states linked to use of artificial tears has prompted experts to offer tips for keeping dry eyes safe.
Five of the 58 people infected with Pseudomonas aeruginosa had vision loss, and one person died, leading to the recall of EzriCare and Delsam Pharma artificial tears. Some of those sickened also reported lung and urinary tract infections.
Tests of opened bottles used by those affected found a rare, highly drug-resistant strain of the bacterium -- one never before reported in the United States, according to the U.S. National Eye Institute.
While it’s unclear if the contamination occurred during or after manufacturing, and while testing continues, there are ways regular users of artificial tears for dry eye disease, contact lens use and refractive surgery can keep themselves safer.
“Formulations with preservatives reduce the risk of bacterial growth and potential infection,” said Dr. Chantal Cousineau-Krieger, an ophthalmologist at the National Eye Institute.
"However, commonly added preservatives such as benzalkonium chloride, polyquaternium, or sodium chlorite themselves can be irritating to the eye, especially if used five or more times a day," she said in an institute news release.
Repeatedly using an eyedrop bottle that contains no preservatives can lead to contamination, increasing infection risk.
“People who require preservative-free artificial tears can purchase single-use, individual dose vials, which cut contamination risk significantly,” Cousineau-Krieger said.
Some preservative-free artificial tears are in bottles designed to prevent contamination. They have a special tip that blocks airflow back into the bottle, keeping the drops sterile longer after opening.
Anyone using eyedrops of any kind should wash their hands beforehand and avoid touching the tip of the bottle to their eye or eyelids, which can increase the risk of contamination.
P. aeruginosa is a considered an opportunistic pathogen, meaning that it tends to cause infection only when defense mechanisms are not working properly -- for example, in someone who is immunocompromised as a result of chemotherapy. Infection can also occur in conjunction with use of contact lenses.
“While infection with the specific, highly resistant bacterial strain at the heart of the outbreak is rare, P. aeruginosa as a bacterial species is everywhere. It lives in soil, ponds and lakes, and even tap water,” said Dr. Suzanne Fleiszig, professor of optometry and vision science at University of California, Berkeley. “Humans have evolved all these defenses. And under normal circumstances, we don’t get infections with opportunistic pathogens.”
Experts said it's important to visit an eye care provider anytime you suspect an eye infection or have symptoms of pain, redness, discharge, sensitivity to light or the persistent feeling that something is in the eye.
“Providers seeing patients with potentially vision-threatening infections need to be especially vigilant about identifying the causative pathogen and determine its antibiotic sensitivity profile to assist in selecting the best antibiotic,” said Dr. Penny Asbell, a clinical professor of ophthalmology at the University of Tennessee College of Medicine.
While not all eye infections need a culture, Asbell recommends culturing if the infection is aggressive, widespread, associated with vision loss and/or not responding to treatment.
An infectious disease specialist can help select the best antibiotics.
“Antibiotic resistance is a growing problem globally. The extensively drug resistant P. aeruginosa strain is new to the United States, and its emergence highlights the risk of extensively resistant organisms,” Asbell said in the release.
If you often need to use artificial tears, get an eye exam to determine what the problem is and what is the safest treatment.
The U.S. Centers for Disease Control and Prevention has more on Pseudomonas aeruginosa.
SOURCE: U.S. National Eye Institute, news release, March 2, 2023
Wataalamu wa afya wametoa mwongozo juu ya matumizi salama ya matone ya macho Jumatatu, Machi 6, 2023 (HealthDay News) - Mlipuko wa maambukizi makubwa ya bakteria katika majimbo 13 ya Marekani yanayohusiana na matumizi ya machozi bandia umewafanya wataalamu kutoa vidokezo vya kuweka macho kavu salama. Watu watano kati ya 58 waliopatikana na Pseudomonas aeruginosa walipoteza uwezo wao wa kuona na mmoja alikufa, na hivyo kusababisha kampuni za EzraCare na Delsam Pharma kukomesha matumizi ya machozi ya bandia. Baadhi ya wale waliogonjwa pia waliripoti maambukizo ya mapafu na ya njia za mkojo. Uchunguzi wa chupa zilizofunguliwa zilizotumiwa na wale walioathiriwa uligundua aina ya bakteria isiyo ya kawaida, yenye sugu sana kwa dawa - moja ambayo haijawahi kuripotiwa hapo awali nchini Marekani, kulingana na Taasisi ya Kitaifa ya Macho ya Marekani. Ingawa haijulikani ikiwa uchafuzi huo ulitokea wakati au baada ya utengenezaji, na wakati upimaji unaendelea, kuna njia ambazo watumiaji wa kawaida wa machozi bandia kwa ugonjwa wa jicho kavu, matumizi ya lensi za mawasiliano na upasuaji wa refractive wanaweza kujiweka salama zaidi. "Mafuniko yenye vihifadhi hupunguza hatari ya ukuzi wa bakteria na maambukizo yanayowezekana", akasema Dakt. Chantal Cousineau-Krieger, daktari wa macho katika Taasisi ya Kitaifa ya Macho. "Hata hivyo, vihifadhi vinavyoongezwa kwa kawaida kama vile benzalkonium chloride, polyquaternium, au sodium chlorite vinaweza kuchochea macho, hasa ikiwa hutumiwa mara tano au zaidi kwa siku, ""alisema katika taarifa ya vyombo vya habari vya taasisi hiyo." Kutumia mara kwa mara chupa ya matone ya macho ambayo haina vihifadhi kunaweza kusababisha uchafuzi, na kuongeza hatari ya maambukizo. "Watu wanaohitaji machozi bandia yasiyo na vihifadhi wanaweza kununua vifurushi vya matumizi ya mara moja, vya kipimo cha mtu binafsi, ambavyo hupunguza hatari ya uchafuzi kwa kiasi kikubwa", Cousineau-Krieger alisema. Machozi fulani yasiyo na vihifadhi yanapatikana katika chupa zilizotengenezwa ili kuzuia uchafuzi. Vipande hivyo vina ncha ya kipekee ambayo huzuia hewa isirudie ndani ya chupa, na hivyo kuweka matone hayo yakiwa safi kwa muda mrefu baada ya kufunguliwa. Kwa hivyo, mtu yeyote anayetumia matone ya macho ya aina yoyote anapaswa kuosha mikono yake mapema na kuepuka kugusa ncha ya chupa kwenye jicho au paji la macho, ambayo inaweza kuongeza hatari ya uchafuzi. P. aeruginosa ni ugonjwa wa kuambukiza ambao huathiri watu ambao hawana mfumo wa kujilinda kutokana na matibabu ya kemikali. Maambukizo yanaweza pia kutokea wakati wa kutumia lensi za mawasiliano. <unk>Wakati maambukizi na maalum, seli seli katika moyo wa mlipuko ni nadra, P. aeruginosa kama spishi ya bakteria ni kila mahali. "Hiyo huishi katika udongo, vidimbwi na maziwa, na hata maji ya bomba, ""alisema Daktari Suzanne Fleischig, profesa wa optometria na sayansi ya maono katika Chuo Kikuu cha California, Berkeley." <unk>Watu wamebuni njia hizi zote za kujilinda. Wataalamu wanasema ni muhimu kutembelea mtoa huduma ya macho wakati wowote unaposhuku maambukizi ya jicho au una dalili za maumivu, mwekundu, kutokwa, unyeti kwa mwanga au hisia ya kudumu ya kuwa na kitu ndani ya jicho. "Watoa huduma wanaowatazama wagonjwa wenye maambukizi yanayoweza kuhatarisha maono wanahitaji kuwa makini sana kuhusu kutambua vimelea vinavyosababisha ugonjwa na kuamua profile yake ya unyeti wa antibiotiki kusaidia kuchagua antibiotiki bora, "alisema Daktari Penny Asbell, profesa wa kliniki wa ophthalmology katika Chuo Kikuu cha Tennessee College of Medicine." Ingawa si maambukizo yote ya jicho yanahitaji utamaduni, Aspel anapendekeza utamaduni ikiwa maambukizo ni ya fujo, kuenea, kuhusishwa na upotezaji wa maono na au kutojibu matibabu. Mtaalamu wa magonjwa ya kuambukiza aweza kusaidia kuchagua viuavijasumu bora zaidi. <unk>Ukinga wa viuavijasumu ni tatizo linalokua ulimwenguni pote. "Kina ""P. aeruginosa"" kinachostahimili dawa nyingi ni kipya nchini Marekani, na kuibuka kwake kunaonyesha hatari ya viumbe vinavyopinga dawa nyingi,"" alisema Asbell." Ikiwa mara nyingi unahitaji kutumia machozi bandia, fanya uchunguzi wa macho ili uone tatizo ni nini na ni matibabu gani yaliyo salama zaidi. Kituo cha Marekani cha Kudhibiti na Kuzuia Magonjwa (CDC) kina taarifa zaidi kuhusu ugonjwa wa Pseudomonas aeruginosa. "Kifungu cha kwanza cha utafiti wa ""Ufahamu wa macho"" wa Taasisi ya Kitaifa ya Jicho, kilichochapishwa na jarida la National Eye Institute, ni ""Ufahamu wa macho"" wa Marekani, uliochapishwa na Taasisi ya Jicho ya Kitaifa, Machi 2, 2023."