Superbug From Recent Eye Drop Outbreak Finds New Host

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Superbug From Eye Drop Outbreak Found in Dogs

Remember that superbug found in various brands of eye drops just a few months ago? Well, it’s reared its ugly head in our canine friends. Recently, two dogs treated at a New Jersey veterinary hospital tested positive for the rare, drug-resistant strain of bacteria, carbapenemase-producing carbapenem-resistant Pseudomonas aeruginosa, which was found in swabs of the dogs’ lungs and ears. The two dogs were from different owners and did not appear to be connected. This strain has been linked to the fatal outbreak caused by the contaminated eye drops used in humans. The bacteria from the dogs was found to be “highly genetically related” to the germs behind the outbreak that sickened 81 human patients in 18 states. This outbreak resulted in 14 patients losing their vision and four deaths.

As a reminder, carbapenemase-producing germs are of particular concern to health officials because they can break down carbapenem antibiotics (eg, imipenem, meropenem, ertapenem, biapenem), a class of drugs typically reserved for infections that are resistant to other treatments. These germs can quickly spread their resistant genes to different pathogens. The CDC’s Emma Price warned that this resistance could spread, now that artificial tears have introduced the bacteria into the United States.

The human eye drop outbreak led to an FDA crackdown across the industry, resulting in millions of other OTC brands being recalled and banned from import. The initial outbreak was attributed to contaminated eye drops produced at a factory in India, where FDA inspectors found dirty equipment and numerous shortcuts in hygiene procedures. The FDA has warned veterinary hospitals and pet owners to check their supplies for these recalled eye drops.

My Two Cents

This story won’t die and seems to have enthralled the public. Although highly concerning, the silver lining is that it has caused many Americans to look at where their eye drops come from and at anything they place in their eyes with more caution. Thankfully, both dogs recovered from the infection and are doing well. The owners also do not recall using the contaminated drops over the past year, traveling internationally, or visiting human hospitals, making this infection a mystery that will hopefully be solved.

OUTSIDE THE LANE

Musician Sustains Eye Injury From Broken Drumstick

A few weeks ago, Justin Hauck was playing the drums on his 31st birthday, when he hit his snare drum for the last note of the performance’s final song. As soon as his drumstick made contact, it “broke clean off, and then, the tip of the stock … must have bounced and flew off right into my eye. Something flicked me in the eye, like, ‘Oh, wow.’ But then, I couldn’t see.”

According to Mr. Hauck, he ended up with a laceration to his eye, which likely resulted in a ruptured globe. He was rushed for immediate surgery and says that he is now safely recovering with stitches in his eye while facing up to three more surgeries. “I can see out of my right eye, but the vision is all weird,” he says.

Mr. Hauck says many other drummers have messaged him, saying what happened to him was a new fear they hadn’t thought of before. He also says that he won’t stop playing the drums; however, he’s going to “probably … wear glasses when I play or some sort of shades or something.”

My Two Cents

I’ve seen my fair share of live music, and honestly, I never thought of a drumstick splintering and damaging the drummer's eye. However, now I’m not sure I’ll be able to watch a drummer and not be concerned about the potential for blindness with every drumbeat. I’m sure many of you will think the same thing the next time you watch a drummer!

CAN YOU RELATE

One of the beautiful things about working at an office with a surgery center is getting all the ophthalmology periodicals sent to the office. There’s nothing quite like curling up at night with a new puppy on my chest and reading through a stack of ophthalmology magazines. No? Am I the only one who enjoys that? Anyway … one of my favorites is Cataract & Refractive Surgery Today (CRST). I especially appreciate the Up Front column that kicks off each issue, similar to Modern Optometry’s Chief Medical Editors’ page.

This month’s Up Front column in CRST is by its Chief Medical Editor William F. Wiley, MD, and in it, he remarks how impressive the dental care system is. Dr. Wiley discusses how the American culture values functional oral hygiene, supports a robust industry of skilled hygienists, and supports preventive treatments, allowing exceptional patient compliance rates. He says we’ve missed an enormous opportunity in eye care and states, “Our current system presents a mismatch in specialty and approach. It is like asking an orthodontist to oversee routine oral hygiene.” Dr. Wiley highlights the eye care profession’s approach to lid hygiene and calls it “alarmingly passive and lacking the systemic rigor seen in oral care.” It is his belief (and I agree) that we should enable all eye care technicians to become “lid hygienists” who advocate and educate our patients based on the importance of regular lid health. He elaborates further that “optometrists should proactively incorporate preventative lid treatments, such as heat therapies and lid scrubs, and make them as routine as annual eye exams.”

Dr. Wiley also emphasizes proper public awareness and suggests this change in mentality will be a win-win for all involved, notably our patients.

First, I cannot applaud Dr. Wiley enough for this short, but compelling, editorial. I currently see as many as 50 patients with dry eye every day, and many of them would be much better off as far as their ocular surface health is concerned if someone—anyone—had taken the time earlier in their lives to inform them of how even a little bit of preventive care could have helped avoid substantial future discomfort. If you have some spare time, I implore you to read Dr. Wiley’s editorial. I can’t imagine anyone being able to compose a more enlightened piece regarding eyelid health.

IMAGE OF THE WEEK

Descemet stripping endothelial keratoplasty detachment.

Paul Hammond, OD, FAAO, @kmkoptometrypro

QUOTE OF THE WEEK

“An ounce of prevention is worth a pound of cure.”

— Benjamin Franklin