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This story will be updated as more information becomes available.

An extensively drug-resistant bacterial strain is spreading in the US for the first time and causing an alarming outbreak linked to artificial tears eye drops, according to an alert released Wednesday evening from the Centers for Disease Control and Prevention. So far, the germ has caused various infections in 55 people in 12 states, killing one and leaving others hospitalized and with permanent vision loss.

Infected patients reported using more than 10 brands of artificial tears collectively, with some patients using multiple brands. But the most common brand used among the patients was EzriCare Artificial Tears, a preservative-free product sold by Walmart, Amazon, and other retailers.