CDC: “Superbug” Spreads To 35 States; Kills 40% Of The People Who Come In Contact

The CDC and LA Times reports a “Superbug” that kills 40% of the people it comes in contact with has hit 35 US States and is now being spread through California medical facilities.



MAP OF THE DAY: There’s A “Superbug” Spreading Around America Killing 40% Of The People Who Come In Contact

LA Times:

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 the 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.

Here’s a map from the CDC of states where it has been reported:

Map of CRE Superbug which kills 40% of people who come in contact and being spread through California medical facilities.

The Centers for Disease Control Writes:

Public Health update of Carbapenem-Resistant Enterobacteriaceae (CRE) producing metallo-beta-lactamases (NDM, VIM, IMP) in the U.S. reported to CDC

Given the importance of Enterobacteriaceae in healthcare-associated infections (HAI) and the extensive antimicrobial resistance found in these strains, all types of carbapenem-resistant Enterobacteriaceae (CRE) are an important public health problem, regardless of their mechanism of resistance or their country of origin. In addition, as Enterobacteriaceae are a normal part of human flora, the potential for community-associated CRE infections also exists. Carbapenem-resistance in Enterobacteriaceae can occur by many mechanisms, including the production of a metallo-beta-lactamase (such as NDM, VIM, and IMP) or a carbapenemase (such as Klebsiella pneumoniae carbapenemase, KPC).

CDC has been working with partners to prevent CRE infections, including those caused by KPC-producing organisms, which are the most common type of CRE in the United States. The KPC gene makes Enterobacteriaceae bacteria resistant to all beta-lactam/carbapenem antibiotics. KPC producers have been reported in about 35 states and are associated with high mortality, up to 40 percent in one report. They may be present in the other 15 states as well, but have not been reported to CDC.  The presence of CRE, regardless of the enzyme that produced that resistance, reinforces the need for better antibiotic stewardship, transmission prevention, and overall HAI prevention in any healthcare setting.

The detection of new mechanisms of carbapenem resistance (ie, metallo-beta-lactamases) in the United States has raised questions about the identification and control of CRE. The mechanism of carbapenem-resistance is of epidemiologic interest but is not necessary for implementation of infection prevention recommendations. Current guidance for the control of all types of epidemiologically important multidrug-resistant organisms is available in the 2006 MDRO Guideline. In addition, see specific guidance for the control of CRE. These recommendations apply regardless of the resistance mechanism.

It is important to note that CRE, unlike other drug-resistant infections such as VRSA, are not a nationally reportable or notifiable disease. Therefore, there is not a requirement to report to CDC and therefore we may not know the true number of infections caused by these organisms in the US (only those voluntarily reported to CDC).

States with confirmed CRE cases caused by the KPC enzyme.

Alabama Arizona Arkansas California (CRE caused by the NDM-1 enzyme and VIM or IMP enzyme) Colorado Delaware Florida Georgia Illinois (CRE caused by the NDM-1 enzyme) Indiana Iowa Kentucky Louisiana Maryland Massachusetts (CRE caused by the NDM-1 enzyme) Michigan Minnesota Mississippi

Missouri Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina Ohio Oregon Pennsylvania South Carolina Tennessee Texas Utah Virginia (CRE caused by the NDM-1 enzyme) West Virginia Wisconsin Wyoming

State(s) with confirmed CRE cases caused by a VIM or IMP enzyme

Washington