A deadly bacteria thought to be resistant to all known remedies has made its way to Los Angeles County medical facilities, officials said this week, adding urgency to the dire need for more powerful antibiotics.
Dr. Dawn Terashita, an epidemiologist with the Los Angeles County Department of Public Health, found 356 cases of a multiresistant form of Klebsiella pneumoniae, also known as CRKP. The pathogen was formerly thought to be contained to the East Coast, but local laboratory results from June to December show that it has spread.
The majority of cases were elderly patients at skilled nursing facilities and long-term care facilities, but lab results also show a small percentage of cases at acute care hospitals.
Long Beach Health Officer Helene Calvet said the bacteria is linked only to hospital intensive care units, and the public is generally not exposed to it.
"It's not a threat to people who are healthy and out in the community," she said.
No cases have been reported at St. Mary Medical Center or Memorial Medical Center, according to officials at those hospitals.
Officials in the South Bay confirmed that they have seen the pathogen in local facilities over the past year.
"It has killed patients here, for sure," said Dr. Brad Spellberg, an infectious disease expert and physician at County Harbor-UCLA Medical Center near Torrance. "This is scary stuff. It cannot be treated with any antibiotic that we know of. ... We're at the point with some of this (resistant bacteria) that we're just mixing a bunch of crap together, throwing it at the patient and crossing our fingers."
A small number of patients at Torrance Memorial Medical Center also have tested positive for CRKP, most of them brought in from nursing facilities, said Elizabeth Clark, director of infection control. These patients are immediately put into isolation, and precautionary measures are taken to prevent its spread, she said.
"We are limited in what we can give these patients," she said.
The findings of Terashita's analysis were to be presented at the Society for Healthcare Epidemiology of America's conference April 1 to 4 in Dallas. The society imposed an April 3 embargo on the study, but the Daily Breeze and other news organizations have decided to publish the results because of the public health concerns involved.
In response to the embargo, the county Health Department scheduled a call today with Terashita to release the results on its own.
Terashita said Wednesday that county officials were surprised to find so many cases in long-term care facilities and nursing homes. The cases weren't sorted by region, but she said they were spread fairly evenly throughout Los Angeles County.
"We don't know if the cases are due to lack of proper care, or have to do with the kind of population (these facilities) serve," she said.
The infected patients were mostly elderly and on ventilators and had stayed at the nursing facility for an extended period, she said. It is not certain whether the nursing home patients brought the pathogen to the hospital or were infected while at the hospital and brought it back with them, she said.
Just 6 percent of cases, however, were reported from hospitals, the analysis showed. The rest were discovered in skilled nursing facilities (38 percent), long-term care facilities (46 percent) and other facilities.
CRKP was first discovered in 2001 on the East Coast and, until now, officials here believed cases on the West Coast were sporadic and isolated.
Spellberg, who recently wrote a book on the subject of antibiotic resistance, said at this point the direction of its spread doesn't matter.
"It's here, and eventually it's going to be found" outside the medical environment, he said. "It's only a matter of time."
Much attention was paid a few years ago to the spread of methicillin-resistant staphylococcus aureus, or MRSA, but Spellberg said a pathogen like CRKP is worse.
"We can treat MRSA," he said. "We have antibiotics for that."
This type of multiresistant bacteria has a double-walled cell, and has developed over time to resist the antibiotics currently approved by the U.S. Food and Drug Administration. Frequent use of antibiotics elevates the risk and prevalence of bacterial resistance as these pathogens evolve over time, experts have warned for years.
Roughly 2 million people contract bacterial infections in a hospital setting each year, and about 90,000 die, according to the Infectious Disease Society of America. Many of these are elderly patients or those with compromised immune systems, but the young and healthy are susceptible as well, officials say.
The findings of the recent local study show the importance of tracking these pathogens and monitoring where and how they spread, said Dr. Arjun Srinivasan, associate director of Infection Prevention Programs at the Centers for Disease Control and Prevention.
"If we want to stop resistant bacteria in their tracks, we have to know where to begin," he said.
Spellberg said the public can do a few things to stem the spread of this bacteria and help in the fight against these so-called superbugs.
"Wash your hands, and stay out of the hospital if you can," he said. "If you are in the hospital, get out as soon as possible. And tell your local elected officials to work to fix this problem."
Staff Writer Joe Segura contributed to this report.