Virginia Mason Medical Center’s Klebsiella pneumoniae bacteria outbreak has been ongoing since last October

By Claire Wolters | Fact-checked by Davi Sherman
Published June 14, 2023

Key Takeaways

  • Virginia Mason Medical Center has been experiencing a Klebsiella pneumoniae bacteria outbreak since last October.

  • Klebsiella pneumoniae are rare but can impact vulnerable individuals, particularly immunocompromised patients in healthcare settings.

  • Putting a stop to the spread may require the center to locate the source of the outbreak while continuing to treat those infected.

Virginia Mason Medical Center (VMMC) in Seattle, WA, has been investigating an outbreak of Klebsiella pneumoniae since October 2022, the source of which remains unknown. Locating the source of the outbreak may be crucial in stopping further spread, as it could indicate a gap in the facility's current cleanliness protocols, or an overuse of antibiotics, according to experts.[]

Klebsiella pneumoniae is a naturally occurring bacteria found in the environment and the digestive tract. Many Klebsiella pneumoniae cases are harmless, but the bacteria can also cause infections—largely in people who are immunocompromised and receiving treatment for other conditions.[]

“This particular organ is not non-common—many people carry this organism as part of their normal bowel flora,” says Adrian Popp, MD, an infectious disease specialist affiliated with New York’s Huntington Hospital at Northwell Health. “But if this particular bacteria gets into places where it's not supposed to be—for example, into the lungs, causing pneumonia [or] into the urine, causing a urinary tract infection—then it becomes a pathogen…that… caus[es] disease.”

Some klebsiella are drug-resistant or considered “gram-negative.” This is harmful in healthcare settings, as it can diminish the integrity of antibiotic drugs and lifesaving healthcare interventions. This particular Klebsiella pneumoniae is drug-resistant to some antibiotics, according to the Public Health Department of Seattle & King County.[][]

The VMMC investigation has confirmed 33 cases of Klebsiella pneumoniae in patients between October 2022 and May 4, 2023. Since the investigation began, nine of the 33 patients have died. Whether or not their deaths resulted from the bacteria or other factors is unknown.[]

“This is indeed an outbreak, where you may have had an original source—a person—with this bacteria, and from there, it’s spread from person to person,” says Popp. An investigation is necessary to determine exactly how the outbreak occurred, he adds.

What are the risks of Klebsiella pneumoniae in healthcare settings?

Klebsiella pneumoniae infections can cause a range of issues, including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis, according to the Centers for Disease Control and Prevention (CDC). These can occur in healthcare settings where patients are treated for other conditions.[]

How does Klebsiella pneumoniae spread?

Klebsiella pneumoniae is not airborne but can be spread via person-to-person contact. This can occur, for example, when patients touch one another or when a doctor who handles more than one patient touches people with contaminated hands.

Those most vulnerable to infections include patients on ventilators, with intravenous catheters, or who have wounds, which may allow the bacteria to more directly enter the body if exposure occurs, according to the CDC. While other people may be less likely to contract the bacteria, they could still be a carrier if exposed and are not in the clear from harm, Popp says.

“You don't want anybody exposed to anything that's drug-resistant,” he adds. “Now, patients who have a weaker immunity for whatever reasons—cancer patients, transplant patients, patients who may be HIV-positive or have other types of immune deficiencies—if they get exposed to more resistant bacteria, they can get ill and can be more difficult to treat.”

For those impacted by VMMS’s Klebsiella pneumoniae outbreak, treatment involves specific antibiotics, like carbapenems, which the bacteria is not currently resistant to, according to the Public Health Department for Seattle & King County.[]

To prevent further spread, the CDC recommends isolation protocols for infected patients and advises others to do their part in preventing further spread by washing hands thoroughly and often, including before preparing or eating food; before touching their face, before and after changing bandages; after using the restroom; after blowing their nose, coughing, or sneezing; and after touching surfaces such as bed rails, bedside tables, doorknobs, remote controls, or the phone.[]

For doctors entering and exiting infected patient rooms, the agency recommends strict adherence to handwashing and wearing gowns and gloves.

In addition to the above protocols, it is important for doctors to take inventory of how they prescribe antibiotics and if their patients are overusing medications, says Popp. If overuse has occurred, he adds that curtailing this for the future and prescribing lower doses (when still effective) can be essential to reducing the risk of future, more drug-resistant bacteria outbreaks.

In a June update on the situation, VMMC states that it is taking steps to reduce risks of further transmission by implementing increased safety controls, such as conducting environmental sampling, updating facility infrastructure, and reviewing its current cleaning practices. It is also working to identify the source of the outbreak and is partnering with the CDC, the Washington State Department of Health (DOH), and the Public Health Department of Seattle & King County to do so.[]

“If you have multiple cases of infection of a certain strain of bacteria, it raises questions about how that facility is run and if there are certain breaks in infection control that allowed transmission to occur where it shouldn't have,” says Popp. “That's why an analysis and investigation has to be done—in a detailed way—to figure out what, if anything, went wrong or what else can be done to prevent such transmission in the future.”

What this means for you

Virginia Mason Medical Center has been experiencing a klebsiella pneumoniae bacteria outbreak since last October, which has been associated with 33 confirmed cases and nine potentially related deaths. Klebsiella pneumoniae are rare, but can impact vulnerable individuals, particularly immunocompromised patients in healthcare settings.

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