Four deaths and 14 cases of vision loss in total have now been reported among more than 80 infections of a rare strain of drug-resistant Pseudomonas aeruginosa that had never been identified in the United States prior to this outbreak. The CDC has also reported four cases of surgically removed eyeballs.
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Patients reported using more than 10 different brands of eye drops - most commonly, EzriCare Artificial Tears, the CDC said. Global Pharma Healthcare's Artificial Tears Lubricant Eye Drops, distributed by EzriCare and Delsam Pharma, were first recalled in February.
In an update this week, the CDC identified 13 more patients in two additional states, bringing the total to 81 patients in 18 states.
Seven of the 13 newly identified patients had specimens collected after the eye product recalls. The majority of those seven patients reported either using the recalled drops or living in long-term care facilities where there were other cases of the bacterial infection.
The US Food and Drug Administration and CDC have urged consumers to stop using the recalled products.
"Patients who have used EzriCare or Delsam Pharma's artificial tears and who have signs or symptoms of an eye infection should seek medical care immediately," the CDC said.
Symptoms can include yellow, green or clear discharge from the eye; eye pain or discomfort; redness of the eye or eyelid; feeling like something is in the eye; increased light sensitivity; and blurry vision.
Pseudomonas aeruginosa is a drug-resistant bacteria that can spread among people who don't have symptoms - and to people who haven't used the eye drops, according to the CDC. This type of spread is particularly common in health care settings.
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"The bacteria can spread when one patient carrying the bacteria exposes another patient, or when patients touch common items or when healthcare workers transmit the germs which is why infection control, like hand hygiene, is so important," the agency previously told CNN.
In April, the FDA said in an inspection report that the Global Pharma Healthcare facility in India did not follow proper protocol to prevent contamination of its products.
The FDA visited the facility for an 11-day inspection that started in mid-February, 2 weeks after the company recalled EzriCare Artificial Tears due to possible contamination.
The inspection of the Global Pharma facility resulted in 11 observations by the FDA, including a "manufacturing process that lacked assurance of product sterility," specifically for batches of product that were manufactured between December 2020 and April 2022 and shipped to the US.
CNN's Deidre McPhillips contributed to this report.
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