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Article continues for 4 more pages.Nearly 100,000 people die every year from bugs that they pick up in health care facilities; experts say most of these infections are preventable
By Coco Ballantyne
CAN HOSPITALS MAKE YOU SICK?: Healthcare facilities are supposed to be places to go to get well, but who knew they could actually make you sicker?
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Kat Gehrke, 25, had no idea that delivering her first baby would lead to the biggest nightmare of her life. On July 5, 2006, Gehrke had a cesarean section at Indian River Memorial Hospital in Vero Beach, Fla.—after more than 20 hours of labor her cervix had not dilated more than 1.6 inches (four centimeters). The procedure seemed to go off without a hitch, and her doctor sent her and new daughter Kaylie home after just two days in the hospital.
All seemed fine, except "my temperature never went back to normal after surgery," Gehrke says. During her first few days at home, she had a low-grade fever that hovered around 100 degrees Fahrenheit (38 degrees Celsius) and she noticed a lump had formed below her incision. By the fourth day, the lump had ballooned to the size of a lime, her fever had jumped to 103 degrees F and her incision was intensely painful. "It was like someone had taken a burning match and stuck it inside" the cut skin, Gehrke says. She immediately went to see her doctor, who took out the staples (as is customary a few days after a C-section) and examined the growing bulge under the wound. He dismissed the pain as normal and prescribed antibiotics for what he diagnosed as a breast infection based on a nickel-size lump that he felt in one breast. But he was wrong. "I didn't have a breast infection at all," Gehrke says, noting that the breast lump was merely a clogged milk duct (common in women who nurse).
A few days later, part of the incision burst open, releasing so much blood and fluid that "the entire [bathroom] floor was soaked in blood," Gehrke says. "My grandma took two beach towels to sop it all up."
Gehrke's grandfather rushed her to Indian River Memorial's emergency room where doctors and nurses cleaned the wound and packed it with gauze to allow for drainage. They sent a sample of the fluid to the hospital lab for analysis and called Gehrke's ob/gyn to inform him that the infection was probably caused by the bacterium Escherichia coli. Gehrke's ob/gyn prescribed sulfa antibiotics, which are commonly used to treat E. coli infections. Two days later, the lab results came back, revealing that Gehrke did not have E. coli, but rather a staphylococcus, or staph, infection caused by methicillin-resistant Staphylococcus aureus (MRSA), a potent bacterium that has developed resistance to most of the old standby antibiotics, making it difficult to treat and potentially fatal.
MRSA causes some 94,000 invasive infections in the U.S. each year, resulting in almost 19,000 deaths—more than those caused by human immunodeficiency virus (HIV)—said a study published this week in JAMA The Journal of the American Medical Association. And "the majority of these cases appeared to be health care–acquired," says Elizabeth Bancroft, a medical epidemiologist with the Los Angeles County Department of Public Health and author of an editorial that accompanied the study.
Learning the infection was MRSA, Gehrke's gynecologist immediately switched her to a stronger antibiotic and put her on bed rest; nurses from the Visiting Nurses Association came to her house daily to pack the wound in gauze and check her vital signs. But the swelling remained and the wound continued to ooze pus.
After three months of this, the wound still had not healed. At the advice of her ob/gyn's partner (who was filling in for her doctor that day), Gehrke went to see doctors at Indian River Hospital's wound care facility. They told her she needed a second operation to remove the tissue destroyed by the infection. Surgeons reopened her incision and discovered a festering infection that had caused extensive damage. It was "like looking at a hole in your belly [that is] seven inches wide and six-and-a-half inches deep," she recalled in an interview with ScientificAmerican.com. After the operation, Gehrke stopped seeing her ob/gyn, but continued to be treated by the wound care physicians and visiting nurses. She says she was mostly bedridden for another three months because it was painful to move while attached to a wound V.A.C., a suction device that aids healing by vacuuming pus, blood and other fluids.
