CHARLOTTESVILLE, Va. — The doctors tried one antibiotic after another, racing to stop the infection as it tore through the man’s body, but nothing worked.

In a matter of days after the middle-aged patient arrived at University of Virginia Medical Center, the stubborn bacteria in his blood had fought off even what doctors consider “drugs of last resort.”

“It was very alarming; it was the first time we’d seen that kind of resistance,” says Amy Mathers, one of the hospital’s infectious disease specialists. “We didn’t know what to offer the patient.”

The man died three months later, but the bacteria wasn’t done. In the months that followed, it struck again and again in the same hospital, in various forms, as doctors raced to decipher the secret to its spread.

The superbug that hit UVA four years ago — and remains a threat — belongs to a once-obscure family of drug-resistant bacteria that has stalked U.S. hospitals and nursing homes for over a decade. Now, it’s attacking in hundreds of those institutions, a USA TODAY examination shows, and it’s a fight the medical community is not positioned to win.

The bacteria, known as Carbapenem-Resistant Enterobacteriaceae, or CRE, are named for their ability to fight off carbapenem antibiotics — the last line of defense in the medical community’s toolbox. And so far, they’ve emerged almost exclusively in health care facilities, picking off the weakest of patients.

USA TODAY’s research shows there have been thousands of CRE cases throughout the country in recent years — they show up as everything from pneumonia to intestinal and urinary tract infections. Yet even larger outbreaks like the UVA episode, in which seven patients died, have received little or no national attention until now.

The bacteria’s ability to defeat even the most potent antibiotics has conjured fears of illnesses that can’t be stopped. Death rates among patients with CRE infections can be about 40 percent, far worse than other, better-known health care infections such as MRSA or C-Diff, which have plagued hospitals and nursing homes for decades. And there are growing concerns that CRE could make its way beyond health facilities and into the general community.

“From the perspective of drug-resistant organisms, (CRE) is the most serious threat, the most serious challenge we face to patient safety,” says Arjun Srinivasan, associate director for prevention of health care-associated infections at the Centers for Disease Control and Prevention.

Since the first known case, at a North Carolina hospital, was reported in 2001, CREs have spread to at least 41 other states, according to the CDC. And many cases still go unrecognized, because it can be tough to do the proper laboratory analysis, particularly at smaller hospitals or nursing homes.

Many hospitals — and an even greater percentage of nursing homes — lack the capacity, such as lab capability, to identify CRE, or the resources to effectively screen and isolate patients carrying the bacteria. And even when screening is possible, there’s a lack of consensus on whom to target.

“We’re working with state health departments to try to figure out how big a problem this is,” says the CDC’s Srinivasan, noting that his agency can pool whatever incidence data states collect. “We’re still at a point where we can stop this thing. You can never eradicate CRE, but we can prevent the spread. … It’s a matter of summoning the will.”

Other experts are less optimistic.

“My concern is that there aren’t a lot of methods in our tool kit that are significantly effective in curbing the spread of these infections,” says Eli Perencevich, a professor and infectious disease doctor at the University of Iowa’s Carver College of Medicine.

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