EzriCare and Delsam Pharma Artificial Tears VIM-GES-CRPA Bacteria Outbreak [Updated]

Updated May 23, 2023, with additional case information

EzriCare and Delsam Pharma artificial tears are the sources of an 18-state VIM-GES-CRPA bacteria outbreak that includes at least 81 patients, according to the Centers for Disease Control and Prevention (CDC). Fourteen patients have suffered permanent vision loss, four people have had an eyeball surgically removed and four people have died.

Since the last update on March 21, 2023, 13 additional cases have been reported. Six of those patients used the product before it was recalled. Most of the seven patients who used the product after the recall are residents of long-term care facilities “with other known cases or reported use of a recalled brand of artificial tears,” according to the CDC.

Verona Integron‐mediated Metallo‐β‐lactamase (VIM)‐ and Guiana‐Extended Spectrum‐β‐Lactamase (GES)‐producing carbapenem‐resistant Pseudomonas aeruginosa (VIM‐GES‐CRPA) is an antibiotic-resistant bacteria that is often spread in healthcare settings. Thirty-seven of the 68 illnesses in this outbreak occurred in four facility-related clusters.

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Between May 2022, and April 2023, the CDC and state and local health departments collected specimens from patients who received treatment at inpatient and outpatient healthcare settings. Eighty-one cases in the following 18 states have been reported: California, Colorado, Connecticut, Florida, Illinois, Nevada, New Jersey, New Mexico, New York, North Carolina, Ohio, Pennsylvania, South Dakota, Texas, Utah, Washington, and Wisconsin.

Whole genome sequencing (WGS) test showed the isolates are closely related to each other and resistant to multiple antibiotics. The genetic sequence type that identifies this outbreak strain has not previously been seen in the U.S.

Isolates that are closely related indicate that the patients shared a common exposure. Most of the patients in this outbreak reported the use of artificial tears before the onset of infection. The brand most commonly mentioned was EzriCare Artificial Tears.

In tests performed on opened bottles of EzriCare Artificial Tears, CDC officials found the presence of VIM‐CRPA. These isolates are undergoing further testing to see if they closely resemble the outbreak strain. They are also conducting tests on unopened bottles of the product. Until all testing is complete, the CDC recommends that clinicians and patients immediately discontinue the use of EzriCare Artificial Tears.


On February 2, 2023, Global Pharma Healthcare issued a recall for EzriCare Artificial Tears and Delsam Pharma Artificial Tears due to possible contamination. The recall includes all products within expiry. Consumers who have purchased these products should not use them.

On February 24, 2023, the company expanded the recall to include Delsam Pharma artificial eye ointment.

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