Evidence map›Paper›PMID 40891389›Full record

ArticleCurrent eye research2026

Could a Preservative Have Prevented the Extremely-Drug Resistant

Eric G Romanowski, Michael E Zegans, Robert M Q Shanks

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Article in Current eye research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Eric G RomanowskiThe Charles T. Campbell Ophthalmic Microbiology Laboratory, UPMC Vision Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Michael E ZegansGeisel School of Medicine at Dartmouth, Hanover, NH, USA.
Robert M Q ShanksThe Charles T. Campbell Ophthalmic Microbiology Laboratory, UPMC Vision Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Funding

Virus Production and Manipulation of Protein/Gene Expression ModuleP30EY008098 · NEI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Ethan A Rossi · 1989 to 2026
$17.8M
Extensively drug resistant Pseudomonas aeruginosa keratitis outbreak strain:  virulence mechanisms and mitigationR01EY036686 · NEI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ROBERT M SHANKS · 2024 to 2026
$1.4M
NEI NIH HHS P30 EY008098NEI NIH HHS R01 EY036686
6 · The paper itself

Abstract

purposeThe 2023 outbreak of extensively drug resistant (XDR) MATERIALS AND

methodsTime-kill studies were performed in Mueller-Hinton broth (MHB) and phosphate buffered saine (PBS) on 3 PA strains including the XDRPA outbreak strain. Preservatives assessed were benzalkonium chloride (BAK) 0.04%, 0.01%, and 0.004%, Polyquaterium-1 (Polyquad) (PQ) 0.001%, Sodium Perborate (SP) 0.1%, and EDTA 0.1%. In addition, time-kill assays were performed using preserved and a non-preserved commercially-available artificial tears.

resultsBAK 0.04% and 0.01%, and PQ eliminated all PA isolates in both media after 4 h. BAK 0.004% and SP eliminated all PA strains in PBS at 1 h but did not produce bactericidal 99.9% decreases in MHB over 24 h. EDTA did not produce a bactericidal effect in either media. Artificial tears containing sorbic acid 0.25% and edetate disodium 0.1%, PQ, SP, and PURITE eliminated the PA strains within 24 h.

conclusionsSeveral common preservatives were effective in eliminating PA strains including the outbreak strain CDC1270. Preservative efficacy was delayed or inhibited in rich media (MHB) compared to PBS. These results suggest that the 2023 outbreak could have been prevented by using a common preservative in the artificial tears.

Indexed as

Disease OutbreaksDrug Resistance, Multiple, BacterialEye Infections, BacterialLubricant Eye DropsPreservatives, PharmaceuticalPseudomonas aeruginosaPseudomonas InfectionsAnti-Bacterial AgentsBenzalkonium CompoundsHumansMicrobial Sensitivity TestsAnti-Bacterial AgentsBenzalkonium CompoundsLubricant Eye DropsPreservatives, Pharmaceuticalartificial tearseye infectionsoutbreakpreservativesPseudomonas aeruginosa

Identifiers

PMID40891389
PMCPMC13231288

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.