Two Artificial Tears Outbreak-Associated Cases of Extensively Drug-Resistant <i>Pseudomonas aeruginosa</i> Detected Through Whole Genome Sequencing–Based Surveillance
Alexander Sundermann, Vatsala Rangachar Srinivasa, Emma G. Mills, M. Patrick Griffith, Kady Waggle, Ashley Ayres, Lora Pless, Graham M. Snyder, Lee H. Harrison, Daria Van Tyne
Abstract
We describe 2 cases of extensively drug-resistant Pseudomonas aeruginosa infection caused by a strain of public health concern, as it was recently associated with a nationwide outbreak of contaminated artificial tears. Both cases were detected through database review of genomes in the Enhanced Detection System for Hospital-Associated Transmission (EDS-HAT), a routine genome sequencing-based surveillance program. We generated a high-quality reference genome for the outbreak strain from an isolate from our center and examined the mobile elements encoding blaVIM-80 and bla-GES-9 carbapenemases. We used publicly available Pseudomonas aeruginosa genomes to explore the genetic relatedness and antimicrobial resistance genes of the outbreak strain.