NEW YORK (AP) — United States (US) health officials are advising people to stop using over-the-counter eye drops that have been linked to an outbreak of drug-resistant infections.

The Centers for Disease Control and Prevention on Wednesday night sent a health alert to physicians, saying the outbreak includes at least 55 people in 12 states. One died.

Disease investigators have linked the infections, including some found in blood, urine and lungs, to EzriCare Artificial Tears. Many of the patients said they had used the product, which is a lubricant used to treat irritation and dryness.

The infections were all caused by a bacteria called Pseudomonas aeruginosa. Investigators detected that kind of bacteria in open EzriCare bottles, but further testing was underway to see if the strains matched.

EzriCare said it is not aware of any evidence definitively linking the outbreak to the product, but that it has stopped distributing the eye drops. It also has a notice on its website urging consumers to stop using the drops.

“To the greatest extent possible, we have been contacting customers to advise them against continued use of the product. We also immediately reached out to both CDC and FDA and indicated our willingness to cooperate with any requests they may have of us,” the company said.

Two weeks ago, the CDC warned medical professional societies about the possible connection between the drops and the infections. The Wednesday alert was a broader, more public warning.

Infections were diagnosed in patients in California, Colorado, Connecticut, Florida, New Jersey, New Mexico, New York, Nevada, Texas, Utah, Washington and Wisconsin. One patient — in Washington — died with a blood infection. At least five others suffered permanent vision loss.

The outbreak is considered particularly worrisome because the bacteria driving it are resistant to standard antibiotics.

Investigators found the bacteria were not susceptible to any antibiotics routinely tested at public health laboratories. However, a newer antibiotic named cefiderocol did seem to work.

How could eye drops cause infections in the blood or lungs? The eye connects to the nasal cavity through the tear ducts. Bacteria can move from the nasal cavity into the lungs. Also, bacteria in these parts of the body can seed infections at other sites such as in the blood or wounds, CDC officials said.

The product is manufactured in India by Global Pharma Healthcare Private Limited, EzriCare said.