March 25, 2011 -- An antibiotic-resistant superbug once thought to be rare is spreading through health-care facilities in Southern California, health officials say.
Roughly 350 cases of carbapenem-resistant Klebsiella pneumoniae, or CRKP, were reported in Los Angeles County between June and December of 2010, according to a study from the L.A. County Department of Public Health to be presented April 3 in Dallas at the annual meeting of the Society for Healthcare Epidemiology of America.
"These patients tend to be elderly, they are commonly on ventilators and they often stay at the facility for an extended period of time," Dr. Dawn Terashita, medical epidemiologist and lead author of the study, said in a statement.
CRKP joins other superbugs such as methicillin-resistant Staphylococcus aureus, or MRSA, in a league of bacteria that outwits typical antibiotics.
"We develop new drugs to defeat the infections and germs change to get around those drugs and this is one of those cases," Dr. Richard Besser, ABC News chief health and medical editor, said today in an interview on ABC News' "Good Morning America."
Besser is a former acting director of the Centers for Disease Control and Prevention in Atlanta.
"It's like an arms race and in many ways the germs are winning," he said.
CRKP is not new to California, or the rest of the country for that matter. The CDC has been tracking it across 35 states since 2009. It is young, however, compared to MRSA, according to Dr. Arjun Srinivasan, associate director of the CDC's health care-associated, infection-prevention programs.
"But in terms of mortality and morbidity, it's very, very serious," Srinivasan said. "These infections are more difficult to treat than MRSA."
CRKP is an enterobacterium like salmonella and E. coli.
It is unclear how many cases of the 350 reported by Terashita and colleagues were fatal. It is also unclear whether the infections stemmed from improper care at long term-care facilities or the frailty of the patients they serve. But Terashita said infected patients tended to have health problems that often resulted in antibiotic use, which might have made them more susceptible.
"All of these factors contribute to a greater risk for health care-acquired infections," she said.
Besser said, "This superbug is very dangerous. It tends to affect people that are in the hospital for long periods of time; people that have underlying medical problems; people who have been in nursing homes."
Although healthy people in the general public are not at risk for infection, they could transmit the bacteria to sick loved ones.
"As a loved one of someone that is in the hospital, you have to be vigilant when you're sitting there with your relative and anyone comes in and wants to touch your relative without washing their hands," Besser said. "You have to say something. ... It does come down to simple things like that, making sure no one is giving a germ to someone you care about."
Health-care workers should be equally vigilant, Besser said.
"A lot of it comes down to hospitals," he said. "They need to make sure that health-care workers aren't spreading it from patient to patient. That's mainly what takes place.
Preventing the spread of CRKP is key because the infections are so difficult to treat, the CDC's Srinivasan said. The "mainstay treatment," colistin, is an older generation antibiotic with toxic side effects. And newer, more effective treatment options are unlikely to be developed any time soon.
Superbug: Not Just in Southern California
Although the report focuses on cases in L.A. county, CRKP was first noticed in New York City.
In a 2010 study by researchers at the Columbia University Medical Center in New York City, for instance, 42 percent of infected patients died within 30 days after infection.
"That's right, there are New York hospitals that have problems, North Carolina hospitals," Besser said. "It's not just limited to California."
The CDC website has a map detailing other affected states.
"If we want to stop resistant bacteria in their tracks, we have to know where to begin," the CDC's Srinivasan said in a statement.
"These findings demonstrate the vital need to monitor drug-resistant bacteria and highlight the important and growing role that state and local health departments are playing in helping monitor and prevent health care-associated infections."