Three men sought help at clinics or emergency rooms in Los Angeles County over a three-month period this year, each reporting severe diarrhea and a recent history of sexual contact with other men.

Stool cultures revealed that all three were infected with Shigella sonnei, a strain of Shigella bacteria that is resistant to five of the antibiotic classes most commonly prescribed for such infections. But upon further analysis, the UCLA researchers analyzing the samples realized they were looking at something altogether new.

All three cases had a distinct genetic mutation that made the bacteria resistant to yet another class of antibiotics, the cephalosporins, which are often used to treat Shigella infections when other drugs fail.

The strain appears to be unique to Los Angeles and has not been recorded anywhere else, said Dr. Shangxin Yang, a UCLA molecular biologist and clinical microbiologist who is a co-author of the paper describing the find. Although all the patients ultimately recovered, the mutation represents an unsettling new development in a battle against a tiny but hardy foe.

“It’s very alarming,” Yang said. “We are dealing with a very stealthy pathogen, and it’s really successful in spreading in a community.”

Two years ago, the U.S. Centers for Disease Control began tracking a sharp rise in cases of extensively drug-resistant (XDR) shigellosis — infections by particular strains of Shigella bacteria that are impervious to most antibiotics.

The Los Angeles County Department of Public Health reported 45 cases of XDR shigellosis in 2023, up from just five in 2021. The antibiotic-resistant infection causes diarrhea, nausea and stomach cramping and is spreading primarily among men who have sex with other men.

The number of cases detected this year declined somewhat from the 2023 peak, with 30 such infections reported in the county.

But Shigella sonnei, the parent strain of the new ultra-resistant bug discovered at UCLA, remains a tricky pathogen for multiple reasons, Yang said.

For one, many infections are either asymptomatic or relatively mild, allowing people to pass the disease to others without realizing they are sick.

It’s a tough bacteria to grow in the lab, which makes it harder for pathologists to identify which particular strain they’re dealing with, he added. And without being able to identify which bacteria is sickening the patient and prescribe the appropriate treatment, the duration of the infection — and period in which it can be spread to other people — is prolonged.

“What we found is probably only a fraction of what’s really in the community,” Yang said.

Most shigellosis patients, even those infected with drug-resistant strains, will get better on their own without a need for antibiotics, said Dr. Daniel Uslan, an infectious disease specialist at UCLA and a co-author of the paper.

But for patients with compromised immune systems, these infections can lead to serious complications that can’t be easily cured. One of the three patients identified in the recent paper, a 62-year-old man with a history of HIV/AIDS and hepatitis C, was ill enough to be admitted to the intensive care unit with septic shock. He was ultimately treated successfully with meropenem, an antibiotic used sparingly as a last line of defense against infections resistant to other medications.

“This is not a cause for panic. It’s a cause for caution and alarm,” Uslan said.

More broadly, the appearance of a new drug-resistant bacteria is a troubling development in the fight against “superbugs,” or pathogens resistant to most available antibiotics.

A study in the medical journal Lancet this year found that without new medications, “superbug” infections could kill nearly 2 million people a year in 2050 — a 67.5% increase from the 1.14 million lives lost this way in 2021.

An additional 8.22 million will die of causes related to those infections in 2050, according to a study from the Global Research on Antimicrobial Resistance Project.

In June, the World Health Organization warned that far too few new antibiotics are in the global development pipeline, and the ones that are there fall far short of the innovation required to vanquish the most dangerous microbes.

“The discovery of any extensively antibiotic-resistant bacteria is alarming, especially in cities like Los Angeles,” said Henry Skinner, chief executive of the AMR Action Fund, which invests in antimicrobial drugs.

“The bacterium detailed in this report is resistant to some of our most widely used antibiotics, including ciprofloxacin and azithromycin — medicines that tens of thousands of patients depend on daily,” he said. “With so few new antibiotics in development, it’s very concerning to learn that an XDR strain of Shigella may be gaining a foothold in the U.S.”

The Biden administration said Tuesday it was offering Pacific Gas & Electric a record $15-billion loan guarantee to help the utility upgrade its transmission lines, which have been blamed in causing wildfires, and make other improvements to meet fast-rising energy use.

The commitment, which still must be finalized, would help PG&E expand hydropower generation and battery storage, the utility said in a release. The money would also help PG&E extend its transmission system to connect with new clean energy facilities.

“Investments in a clean and resilient grid for Northern and Central California will have significant returns for our customers in safety, reliability and economic growth,” said Patti Poppe, the company’s chief executive.

The company said the loan would come with a lower interest rate than what it could otherwise obtain and save customers as much as $1 billion over the years.

“We would pass along savings from our lower cost of debt to our customers as we work to modernize the grid and stabilize customer bills,” said Lynsey Paulo, a PG&E spokesperson.

Electric rates at the utility have soared by 56% over the last three years, according to a new report by the Public Advocate’s Office at the state Public Utilities Commission, more than either Southern California Edison or San Diego Gas & Electric.

This year, PG&E hiked rates four times. The company’s rate requests must be approved by the utilities commission, whose members are appointed by Gov. Gavin Newsom and confirmed by the state Senate, which is controlled by a supermajority of Democrats.

Last year, the company recorded $2.2 billion in profits — an increase of almost 25% over the year before.

Paulo said the company was now trying to keep average annual residential gas and electric bill increases within 2% to 4% through 2026.

The announcement of the federal loan drew skeptics on Tuesday.

“This loan is less a solution for California’s energy future and more a bailout for PG&E,” said Ken Cook, president of the Environmental Working Group, a nonprofit advocacy group. “Somebody must repay it, and it certainly won’t be the company’s shareholders or executives.”

The Biden administration has been hurrying to release more money from the 2022 Inflation Reduction Act before President-elect Donald Trump takes office in January.

The loan guarantee is the biggest commitment to date from the Department of Energy’s Loan Programs Office. The money would be provided to PG&E in installments over several years. Loan office officials must approve the projects it pays for.

Federal officials said the company must still satisfy certain technical, legal, environmental and financial conditions before the loan is funded.

In 2019, Pacific Gas & Electric announced a $13.5-billion settlement for several Northern California wildfires sparked by its equipment that killed dozens of people and destroyed thousands of homes and businesses. Those fires included one that nearly destroyed the town of Paradise in 2018, the deadliest in state history.

The company had filed for bankruptcy earlier that year. It reorganized and emerged from bankruptcy in July 2020.

On a grassy hillside just east of downtown Los Angeles, a few dozen mourners gathered last week to pay respects to 1,865 people whose names they did not know — men, women and children whose ashes recently joined the remains of 100,000 others laid to rest here since 1896.

The departed interred at Los Angeles County Cemetery had one thing in common, and one thing separating them from those on the other side of the rusty chain link fence demarcating the county plot and neighboring Evergreen Cemetery: they had neither the means for a private burial, nor family to claim their bodies.

Each year in December, those whose remains have been unclaimed for three years are memorialized with an interfaith ceremony. On Thursday, members of the public looked on in respectful silence as representatives of L.A.’s many faiths acknowledged the dead the way they might have wanted: with a Buddhist chant, a smudging of sage, the Lord’s Prayer in Swahili, Hindi and Spanish.

The blessings said over the freshly turned earth hinted at the lives once lived. Many were unhoused. A small handful were never identified. Some were children.

Brian Donnelly drove from Hollywood to witness the ceremony. He suspects a number of the unhoused people he’s come to know from his neighborhood over the years are interred here, he said.

“I think it’s important,” he said of the ceremony, his voice catching. “You come into this world with somebody. You don’t deserve to go out alone.”

In recent years, those who track the way we live and die have noticed a disquieting change.

While there are more tools than ever to identify the unknown dead and track down surviving family members, the percentage of people whose next of kin cannot — or choose not — to claim their remains is increasing, a shift sociologists attribute to changing family dynamics, growing mobility and an epidemic of loneliness.

To go unclaimed “is kind of an exclamation point on a life that was marked by social isolation, especially in later years,” said Pamela Prickett, an associate professor of sociology at Pomona College. “We’re not fully grasping just how much our sense of what we owe each other has changed.”

Prickett is the author, with UCLA sociologist Stefan Timmermans, of “The Unclaimed: Abandonment and Hope in the City of Angels.” In their research, Prickett and Timmermans found, less than 1.2% of those who died in L.A. county in the 1970s were unclaimed by next of kin. In 2013, the most recent year from which data is available, 2.75% of county decedents were not picked up.

That number has continued to rise, the researchers write, both in Los Angeles County and beyond. The percentage of decedents unclaimed in Maryland, one of few states that maintains such records, was 2.1% in 2000 and 4.5% in 2021, the book notes.

To be unclaimed does not in itself mean that a person was unloved in life or unmissed in death. Prickett sees it as the culmination of several significant shifts in the way we live, the net effect of which becomes apparent only once we’ve died.

When the county picks up a person who has died in a facility, residence or public area, and no will or person with power of attorney can be found, the Office of Decedent Affairs and the public administrator work to locate next of kin and determine if the deceased died with any assets. If the county can’t find any living relatives but the deceased had enough savings, the public administrator arranges for a private burial.

Longer lifespans increase the likelihood of a person outliving siblings, spouses and even adult children who might step forward to claim them. They also increase the chance that a person will outlive their financial resources.

“Because somebody died at that moment without money doesn’t mean that the years preceding that were ones in which they didn’t have money,” Prickett said. “It might just be that the nursing home costs zapped their savings.”

If the person died penniless but the notified next of kin does not pick up the body, the county arranges for cremation. It stores the cremated remains for three years, in case a relative comes forward to claim them. Very often, they don’t.

L.A. County charges roughly $400 to pick up cremated remains. Many next of kin lack the ready cash, or the wherewithal to navigate the legal process to waive the fee.

Genealogist Megan Smolenyak is the founder of Unclaimed Persons, a team of volunteer researchers who have assisted local jurisdictions, including L.A. County, in tracking down next of kin.

Some tell Smolenyak that the quality of their relationship with the deceased doesn’t justify the cost of picking up their ashes or arranging a funeral.

“Sometimes, even when there’s quite close living relatives, they just won’t accept the responsibility of being next of kin because they can’t afford it,” Smolenyak said. “It’s like, “I haven’t heard from them in 20 years, and I can’t just afford a funeral out of the blue.’

The COVID pandemic may have further weakened family connections. With restrictions on travel and hospital visitations, final reconciliations with family that may have happened in other years simply didn’t, said the Rev. Chris Ponnet, a Catholic priest and director of spiritual care at Los Angeles General Medical Center.

“It was just a lot of people, all alone,” he said.

Those whose ashes were buried this week died in 2021. The county has not yet released the names of those interred, which will eventually be publicly available in case long-lost kin come seeking them.

On one side of the chain link fence ringing the county cemetery, the brilliant red of tinsel and fresh poinsettias adorning Evergreen graves stood out against the gray stone and sky. On the other, the people of Los Angeles went about their business — some of them lonely, some of them unhoused, some unaware that they were passing the place they will one day come to rest.