Bacterial Infections

[JohnnyV 14]

Limb loss due to Bacterial Infections is on the rise. I am hearing about it happening more and more as of lately and have a friend who is hospitalized with his 3rd outbreak in 6 months and is looking for help.

Here is a link that tells all about it:

http://www.amputee-coalition.org/easyread/..._warfare-ez.pdf

[mmarie 13]

JV - haven't heard from your friend yet. If I don't hear from him after a couple of days from Christmas, I will contact him. I didn't lose my leg from MRSA; I contracted it after amputation surgery and then again last year, supposedly from a socket rubbing that caused a hematoma. The dr told me then blood is an excellent medium for the bacteria. Personally, I think once you have it, it's always there lurking, waiting for a place to colonize.

Hope he is doing okay.l

[cherylm 125]

Johnny, MRSA was the creature that ultimately cost me my leg... after a little over a year of "save" attempts to repair my stubborn fracture, and the onset of Charcot Foot, a bone fragment punctured the sole of my foot and the bacteria entered there and went about "colonizing" me. Darn near killed me, too!

I was very weak at the time that the MRSA set in. I hope your friend is in a better state than I was and is able to help fight the infection. It is indeed "beatable," but it can be a miserable thing! I'll be thinking good thoughts for your friend.......

[Joe H. 0]

Infections - what a fun topic. I had a bout with infection when I first got hurt. don't know what it was but I was in the hospital for 45 days when I got injured, a lot of that time was caused by infection. Was on Vancomycin all that time plus another 30 days of treatment from home. Two bottles a day through the PIC line at $565.00 a bottle. That was when they were trying to save my leg.

After I had my amp, I got my first leg a couple of months latter. Had it for 3 days and a screw head came through my skin. After not being on 2 feet for 11 months I didn't want to say anything. Well, a few days later I got sick, still didn't go to the doctor. A few days after that I was back in the hospital, they said my organs were starting to shut down by the time I got there. Luckily, it was not MRSA, it was a strep infection. They were able to treat it with Penicillin, although I had to have another PIC inserted and a constant drip for 6 weeks.

I lerarned that infection is nothing to mess around with.

Tell your friend good luck and I will keep him in my prayers.

Joe

[Chrissy 1]

MRSA was a part of my life for several years and did play a part in my amputation. I had lymphangiomatois in my left leg since birth. In March 2005, I had two massive hematomas in my leg. It ended up swollen and filled with blood, which became the perfect breeding for bacteria. An egg-sized abyss formed on my knee and eventually broke open, and all the blood just spurted out like a geyser, which was infected with MRSA. I was left with a hole in my knee that never healed. The MRSA colonized around hardware (rod and pin) that was in my femur from a fracture years prior. I battled MRSA outbreaks one after another. I can’t tell you how many times I was on Zyvox or how many nights I had to lay on my bed squeezing my leg while cups of orange puss drained out. I had my leg surgically cleaned out two times before they finally decided to remove the hardware in the spring of 2007. I almost died from the blood loss after the surgery. After I made it through that the doctors were hopeful that the removal of the hardware would end the MRSA infections. It didn’t. Another MRSA outbreak returned in Jan, 2008 which was treated. The doctors said I most likely would continue to suffer from MRSA infections and eventually, my body would no longer be able to fight them and I would die. That is when I decided to have my leg amputated and spent 2008 planning the surgery, which occurred Feb 10, 2009. They even tested me in the hospital for MRSA the day of my amputation with a swab test in my nose. It came up positive, even though I did not have a MRSA infection. The nurses told me that even though I did not have an infection, I would most likely always test positive. Now I am just waiting from my incision to heal, which is going very slowly. I do worry that I could develop another MRSA outbreak.

[cherylm 125]

The sheer amount of pus that MRSA can create is astonishing. When I first arrived in the hospital, they made an attempt to surgically clean out my foot and assess the damage. Because I was so medically fragile at the time, this procedure was carried out under just local anesthesia... I was fully awake for the whole thing.

I saw the surgeon approach my foot to make the incision, and then I heard a loud and disturbing "SPLAT." "How bad is it?" I asked, and he replied "It's very bad, Cheryl."

Then a nurse asked, "Do you want a bucket for that, Doctor?" The answer was in the affirmative, and a bucket was produced. More "SPLATs." At that point, I just tried to keep from throwing up.

[Chrissy 1]

Yeah Cheryl, the puss was fun stuff! I actually was never grossed out by it for some bizarre reason. It never bothered me. I could just lay there draining my leg and the puss would be pouring out and I would just be watching TV totally unfazed by it. It was my routine every night before bed. It was almost a reassuring feeling of relief to see it. Maybe because it meant to me the infection was coming out of my body. I don’t know. Just never had a problem with it.

I heard very similar words from my doctor as well. When I developed the MRSA that forced them to take the hardware out of my leg, I had an abscess up on my hip. I was laying there on a table in the doctor’s office while the surgeon cut it open to drain. He just kept saying, “Christina, this is bad. This is very bad.” He threw my butt in the hospital so fast. Was always ok with the puss. Now blood spurting out my leg. That’s another story!

It still worries me that my history with MRSA is not over. It has been 9 weeks since my amputation, and my incision is still very much open and draining. It is nowhere near healed and I am beginning to feel it never will heal, that eventually the MRSA will set in.

[benc 0]

Well i think mrsa has a bit to do with my amputation which was 2 years ago today i think (too drugged up to remember). I had crushed all the blood vessels in my leg and with the mrsa they wouldn't heal. so they amputated and a while later i was clear of mrsa.

2 years later ive had puss coming out of my "good" leg for the last 6 months on and off, luckily its not mrsa but still its not fun. My bone has now healed so they can take the metal work out and hopefully ill be infection free in the next few months after the surgery. Then i can finally get my knee and drop foot fixed, why do these things take so long? my physio and people think im mad learning to run now but why let these little things slow you down?

[mmarie 13]

I had MRSA about a week after my amputation. Hospital acquired, I'm sure. Wound up having to have about 2 more inches of leg amputated. That was in Jan of 04. In Sept of 07 I had developed a tennis ball size "thing" on my lower inner thigh. When I went to the dr, at 9:30am, he wanted me to go directly to the outpatient surgical center next door. Having eaten breakfast about an hour earlier it couldn't be done right then. The dr took drew some yukky stuff out, put the syringe in a baggie and sent us to the hospital, telling my husband to take it directly to the lab. At 2:30 that afternoon I was in surgery.

At the time, my prosthesis was not fitting well, rubbing on my thigh. The drs think it caused a hematoma and the bacteria found a good home.

At a follow up visit to the surgeon, while waiting for the dr, my husband and I were reading the file. The surgery notes stated that upon making the incision an "abundant" amount of pus was released. Yuk. Abundant...gross.

MRSA is bad stuff. I still wonder if it will come back.

[cherylm 125]

I've been told that, once you've been "colonized" by MRSA, it has a tendency to return... but I've been free for over four years, now...... (Hooray!)

[SteveAZ 0]

My original limb-loss in '07 was caused by a very drug resistant pseudomonas aeruginosa. Nasty stuff; pretty much certainly hospital acquired.

I was having trouble with a lump in the residual limb and I went in for a revision last year. It turns out the lump was a ball of scar tissue that formed around a stitch that was left behind from the amputation.

I got MRSA from that surgery. I was expected to go back to work three days following that surgery. Even though I was in horrible pain with tons of swelling the week following the revision the surgeon was very condescending and clearly in denial about much of anything being wrong and completely in denial about infection until he opened it up two weeks following the revision and it was "totally involved". I was not on best behavior in the hospital following that news.

Four surgeries, a week and a half in the hospital and I almost had to "break out" to go home. Six weeks of IV infusions three times a day.

With the exception of some fitting issues with the new prosthetic I'm good now! Woohoo!!!

Damn these hospitals though. From what I can see there is so much complacency regarding preventing these infections. I think very simple steps could be taken to prevent a lot of this.

I'd like to find an effective avenue for advocacy to spend some time to try and change things. I haven't figured out what would get the best bang-for-buck for my time though...

[sarahsaifa 0]

Just thought I'd pipe in, as an amputee and a microbiologist this is a particular area of interest for me. Also, if you have any questions regarding infectious diseases, I might be able to help you out! :)

To SteveAZ, you're right about the complacency regarding hospital acquired infections. Unfortunately the magnitude of these infections is likely to go unnoticed until the hospital has some compulsory reporting system in place. Then, when they have all the data and can actually look at the numbers, they realise they need to do something and are no longer so complacent. Although I don't think this is standard practice, because hospitals don't want people to know what's really going on. Even if it means ignoring a problem.

The most recent case of this I can think of is in the UK, lots of hospital acquired C. difficile infections happening but no data collection. I believe they made C. difficile infections compulsory to report and also introduced a mandatory target to reduce the numbers of infections. Once this was implemented, inpatient mortalities reduced from about 8000 to about 4000 in just 2 years. So the point of my little rant is, if you're interested in advocating for change regarding hospital practices, it might help to start with some investigations into what sort of reporting procedures they have in place, and the overall variability of diagnosis and detection of your pathogen of interest across different hospitals, which is likely to have some impact on the number of detected cases.

And don't forget everyone, don't let anyone in a hospital (medical professional or otherwise) touch you until you've seen them wash their hands!