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‘Superbug’ spreading to Southern California hospitals

Posted on: March 26, 2011

A dangerous drug-resistant bacterium has spread to patients in Southern California, according to a study by Los Angeles County public health officials.

More than 350 cases of carbapenem-resistant Klebsiella pneumoniae, or CRKP, have been reported at healthcare facilities in Los Angeles County, mostly among elderly patients at skilled-nursing and long-term care facilities, according to a study by Dr. Dawn Terashita, an epidemiologist with the Los Angeles County Department of Public Health.

It was not clear from the study how many of the infections proved fatal, but other studies in the U.S. and Israel have shown that about 40% of patients with the infection die. Tereshita was not available for comment Thursday morning but was scheduled to speak about the study in the afternoon.

“These are very serious infections, hugely complicated by the fact that the treatment options are severely limited,” said Dr. Arjun Srinivasan, associate director for healthcare-associated infection-prevention programs at the federal Centers for Disease Control and Prevention in Atlanta.

The L.A. County Department of Public Health describes CRKP as an antibiotic-resistant organism that “can cause infections in healthcare settings, including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis.”
The pathogen is even resistant to specialized drugs developed to treat difficult infections. “This is considered a threat to patient safety,” according to the county, because such antibiotics “often are the last line of defense.”

Unlike other superbugs such as methicillin-resistant Staphylococcus aureus, or MRSA, the CRKP pathogen is an enterobacterium, in the same “lethal family” of bacteria as E. coli, Srinivasan said.

“We’ve been monitoring the rise of this organism for a few years at CDC,” he said. “Initially, it was first described in North Carolina, and then we started getting reports in the New York and New Jersey area. We are seeing reports of this organism all over the country now.”

He stressed that unlike MRSA and other superbugs, CRKP has not spread in communities but remains confined to healthcare facilities.

“The key is that it remains pretty rare in most places,” he said, although, “there are pockets of the country where they are encountering this a lot, like New York City.”

The superbug is usually treated with the antibiotic colistin, which is so strong it is often toxic to patients but in other cases has not proved strong enough to overcome the bacterium, Srinivasan said.

The CDC recommends an aggressive approach in preventing the spread of the bacterium, including isolating infected patients and testing those around them.

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