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Two more people have died and more details of horrifying eye infections are emerging in a nationwide outbreak linked to recalled eye drops from EzriCare and Delsam.

The death toll now stands at three, according to an outbreak update this week from the Centers for Disease Control and Prevention. A total of 68 people in 16 states have been infected with a rare, extensively drug-resistant Pseudomonas aeruginosa strain linked to the eye drops. In addition to the deaths, eight people have reported vision loss and four have had their eyeballs surgically removed (enucleation).

In a case report published this week in JAMA Ophthalmology, eye doctors at the Bascom Palmer Eye Institute, part of the University of Miami Health System, reported details of one case linked to the outbreak—a case in a 72-year-old man who has an ongoing infection in his right eye with vision loss, despite weeks of treatment with multiple antibiotics. When the man first sought treatment he reported pain in his right eye, which only had the ability to detect motion at the point, while his left eye had 20/20 vision. Doctors noted that the white of his right eye was entirely red and white blood cells had visibly pooled on his cornea and in the front inner chamber of his eye.

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Jianhua Guo is a professor at the Australian Centre for Water and Environmental Biotechnology. His research focuses on removing contaminants from wastewater and the environmental dimensions of antimicrobial resistance. One of those dimensions is the overuse of antibiotics, which promotes resistance to these drugs.

Guo wondered if the same might hold true for other types of pharmaceuticals as well. His lab found that they definitely do. Specific antidepressants—SSRIs and SNRIs—promote resistance to different classes of antibiotics. This resistance is heritable over 33 bacterial generations, even once the antidepressant is removed.

So much work

Antidepressants are among the most prescribed and ingested drugs there are. They account for roughly 5 percent of the pharmaceutical market share—about the same as antibiotics—and four of the top 10 most prescribed psychiatric meds in the US.

Colorized scanning electron micrograph of Neisseria gonorrhoeae bacteria, which causes gonorrhea. (credit: NIAID)

The most highly drug-resistant cases of gonorrhea detected in the US to date appeared in two unrelated people in Massachusetts, state health officials announced Thursday.

The cases mark the first time that US isolates of the gonorrhea-causing bacterium, Neisseria gonorrhoeae, have shown complete resistance or reduced susceptibility to all drugs that are recommended for treatment.

Fortunately, both cases were successfully cured with potent injections of the antibiotic ceftriaxone, despite the bacterial isolates demonstrating reduced susceptibility to the drug. Ceftriaxone is currently the frontline recommended treatment for the sexually transmitted infection.