Outbreak of Extensively Drug-resistant Pseudomonas aeruginosa Associated with Artificial Tears. On February 01, 2023 , CDC issued a Health Alert Network Advisory about infections with an extensively drug-resistant strain of Verona Integron-mediated Metallo-β-lactamase (VIM) and Guiana-Extended Spectrum-β-Lactamase (GES)-producing carbapenem-resistant Pseudomonas aeruginosa (VIM-GES-CRPA) in 12 states.  CDC is collaborating with the Food and Drug Administration (FDA) and state and local health departments to investigate the outbreak. The investigation to date has identified artificial tears as a common exposure for many patients. CDC and FDA recommend clinicians and patients stop using EzriCare or Delsam Pharma’s Artificial Tears products pending additional guidance from CDC and FDA. 

As of March 01, 2023, Virginia has not identified cases linked to this outbreak. Clinical laboratories and healthcare professional should continue to follow the Virginia Reportable Disease list which states: 

• Clinical laboratories should forward all carbapenem-resistant Pseudomonas aeruginosa isolates to the Division of Consolidated Laboratory Services (DCLS) for further public health testing 

• Healthcare providers should report all carbapenemase-producing organisms (CPO), infection or colonization, to your local health department (LHD) 

1. For physicians and directors of medical care facilities to report to the health department not only when a person who is infected with or who is suspected of having COVID-19 is treated or examined, but also if the person is hospitalized or admitted into an intensive care unit;  
2. Clarity that the category "laboratory directors" includes pharmacies that hold Clinical Laboratory Improvement Amendments Certificates of Waiver so that pharmacies testing for COVID-19 are required to report to VDH;  
3. Specificity that only positive SARS-CoV-2 test results shall be reported;  
4. That the patient telephone number and ethnicity be included in the list of fields that are reported by physicians, laboratory directors, and directors of medical care facilities; and  
5. That "coronavirus, severe" is added to the list of infectious diseases that shall be reported to persons practicing funeral services.  

To view the edited text, visit the Virginia Regulatory Townhall site here. 

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Investigation of a Candida auris Outbreak in a Skilled Nursing Facility – Virginia, United States, October 2020 – June 2021. In December 2022, VDH staff from the Alexandria Health Department and the HAI/AR Program published their report on a C. auris outbreak investigation at a Virginia ventilator-capable skilled nursing facility (vSNF). Candida auris is an emerging multidrug-resistant organism (MDRO). During October 2020–June 2021, the facility identified 28 cases among residents in the ventilator unit. They detected multiple infection and prevention control challenges, highlighting the importance of strengthening MDRO prevention efforts at vSNFs. Read more from the American Journal of Infection Control.  

Vital Signs: Health Disparities in Hemodialysis-Associated Staphylococcus aureus Bloodstream Infections, 2017-2020. Health disparities are inequitable and are directly related to the history and current unequal distribution of social, political economic, and environmental resources. Racial and ethnic minorities are disproportionately affected by end-stage kidney disease (ESKD). A study was conducted to discover how ESKD patients on dialysis are at increased risk of Staphylococcus aureus bloodstream infections, while also taking a closer look at the racial, ethnic, and socioeconomic disparities associated with this outcome.