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An Infection I Just Couldn’t Shake
What happens when even the most potent antibiotics don't work? A personal tale from the front lines of the fight against potentially deadly bacteria.
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Last fall, when a nurse hung a bag of the antibiotic vancomycin on my IV pole, I had no idea that it had once been known as the antibiotic of "last resort." When you go in for scheduled surgery, as I did, your doctors will warn you that infections are one of the risks. What they didn't say was exactly how common they are and how often they become life-threatening. Before it was all over I became just one of 2 million Americans who get some kind of infection in a health-care setting each year. Seventy percent of those bugs are resistant to at least one kind of antibiotic.
In recent days the media has focused on MRSA (Methicillin-resistant Staphylococcus aureus), one of the more dangerous infections, which is blamed for the death of a 17-year-old high-school football player, among others. But MRSA is only a small part of the problem. There were 18,000 reported MRSA deaths in 2005—just a fraction of the nearly 100,000 deaths from all hospital-acquired infections.
My first bout with one of these superbugs came in July 2006, when, a few days after surgery to repair damaged nose cartilage, I woke to find the entire right side of my face swollen and my right eye completely closed. My doctors told me to get back to the hospital immediately. I was worried, of course, and I looked pretty scary, but I was a healthy 43-year-old—surely, I thought, there were plenty of powerful antibiotics that would kill the bacteria and set me right in a matter of days. Over the next two months I'd find out exactly how wrong I was.
That infection eventually put me back in the hospital two more times, for a total of 14 expensive and debilitating days. My doctors kept me in a little longer each time, hoping to give the IV antibiotics more time to kick in. It took a final eight-day stay in September to finally quell the infection. Most of the time I was in pain, but not really scared. However, at one point during that last long hospitalization, my blood pressure dropped to 78 over 50, and it finally dawned on me that the doctors might not be able to kill the bacteria that were colonizing my body. The drop in pressure was terrifying. It was a little like being in a dream where you think you're running, but you're not moving at all. Just reaching over to press the nurse call button was a huge effort, and there was a distinct feeling that my body was losing a battle.
During that period my doctors tried various combinations of the most powerful antibiotics as they struggled to find something that would stop the infection from spreading either into the new cartilage they'd just grafted into my nose or, worse yet, into my bloodstream, where it could make my whole system lethally septic. (Luckily, that never happened.) They brought in a rumpled Peter Falk-like infectious disease specialist who patrolled the halls of the hospital like a medical detective, ordering up cultures for the many patients like me fighting an onslaught of microbes impervious to pharmaceuticals.
The pattern of infection and treatment became familiar. They'd hospitalize me and start an IV, and after a day or so I'd feel fine. They'd release me with the pill form of an antibiotic, and then within a week or two the infection would out-evolve the drugs, which usually don't work as well when they're not administered intravenously. After a while I could tell when those bacterial armies were building strength even before the swelling and redness made it obvious. It was like the beginning of a horrible flu, a draggy, muddy feeling that clouds the mind.
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