Triathlete Battles Rare, Virulent Strep Infection

A 35-year-old Santa Barbara triathlete stricken with a rare and virulent streptococcus infection that has become notorious as “flesh-eating” bacteria was improved Thursday afternoon, but remained in critical condition at Sherman Oaks Hospital’s burn center.

The infection is the same type that set off alarming news reports when a cluster of seven cases was reported in Gloucestershire, England, this spring, followed by a number of reports in the United States. In this instance, it apparently entered through a shaving cut on the victim’s leg during a bicycle ride Sunday afternoon and spread rapidly, doctors said.

Bernie Donner, a Santa Barbara lifeguard and swim camp counselor, has already lost half the muscle tissue in his left leg to the infection, known as necrotizing fasciitis, physicians said.

But doctors are hopeful that they have stopped the infection from spreading to Donner’s abdomen, which almost certainly would have been fatal, said Dr. A. Richard Grossman, the burn center’s medical director.

Donner spent most of Thursday in the hospital’s pressurized hyperbaric chamber, which forces more oxygen into the blood. This makes it a less hospitable place for necrotizing fasciitis bacteria, which thrive in an oxygen-poor environment, Grossman said. “They love dark, dank places,” he said.

Donner was delivered by helicopter to the burn center Wednesday night after being treated by doctors at Santa Barbara Cottage Hospital.

Today, Donner will undergo surgery to remove dead tissue from his ravaged leg. Doctors will also close the wound, which extends from Donner’s groin to his ankle, with skin from a cadaver, Grossman said.

On Monday, Grossman said, “we will begin to graft that wound with his own skin.”

Donner is lucky to be in excellent physical condition, he added, which helped fight the infection.

Necrotizing fasciitis is a deadly strain of a common and ordinarily much weaker germ, Group A streptococcus. When Group A strep invades the softer tissue of the abdomen, said Grossman, it “literally ends up eating a hole in the belly from the inside out.”

In Donner’s case, “fortunately, it stopped at his pelvis,” he said. “If we can get through the next four days, pumping him full of antibiotics, plasma, and getting him through the next two operations, he might be out of the woods.”

Donner is also lucky that his mother is a retired nurse.

When he became sick with nausea and vomiting Sunday night, she insisted over his objections on rushing him to Santa Barbara Cottage Hospital. He was admitted there about 11 p.m.

Besides the toxic strep infection, Donner was also suffering from toxic shock caused by a staphylococcus bacteria and his condition rapidly worsened, Grossman said, until by 1:30 a.m., “his blood pressure was 70 over nothing.”

Grossman said Donner apparently acquired the airborne toxic strain of the disease through a small cut that he received while shaving his legs--a practice common among competitive bicylists--before going out for a 35-mile ride Sunday near Santa Barbara.

Grossman said he did not know the exact route that Donner took on that ride, but said he could have picked up the bacteria “just riding along Pacific Coast Highway.”

On Wednesday, Donner underwent five hours of surgery to remove dead tissue from the infection site from his left thigh down to his ankle. Samples of that tissue revealed that he had raging infections from both the Group A strep and staph bacteria.

Donner has been a well-liked summer staff member of the Santa Barbara Parks and Recreation Department for the past five years, said Joan Russell, the department’s recreation programs manager.

“He’s great . . . and we’re concerned about him,” she said. “He works very well with kids and he’s very responsible.”

The federal Centers for Disease Control and Prevention estimates that in 1990, the last year for which it gathered figures, there were 10,000 to 15,000 severe cases of Group A strep in the United States, resulting in 2,000 to 3,000 deaths. Of those, 500 to 1,500 included necrotizing fasciitis.

Although the incidence of the infection is up from the early 1980s, the numbers are minuscule compared with the many thousands of routine strep throat infections reported each year. The organism is so common that it has been called “an occupational disease of schoolchildren.” Experts estimate that 10% to 15% of all pupils are infected at any given time.

Russell said that during the rest of the year, Donner, a trained private investigator, works for his father, who is also an investigator.

Donner’s family declined to be interviewed.