Staph gets personal

Nov. 28, 2007

I took an interest in Staph infections four years ago after meeting my neighbor, Deb Farron. She was just recovering from a Staph infection that nearly took her life. In retrospect, she was fortunate that it wasn’t MRSA, but just a “normal” Staph infection.
Staphylococcus comes from the Greek word staphyle, meaning a bunch of grapes, and kokkos meaning berry. And that’s what this bacteria looks like—a bunch of grapes or berries. It can live innocently on your skin—or ride around in your nose. About 30 percent of us carry it with no problems.
Infections can occur when the bacteria breaks through a simple cut or from a surgeon’s incision. Staph can first appear as a pus-filled boil that’s red and painful and looks like a spider bite. That’s just the tip of the iceberg—underneath festers a larger infection. Most are minor and the doctor will recommend a triple antibiotic salve or an oral antibiotic. Problem solved. But Staph isn’t always impetigo or a boil. It can get into your bloodstream and damage your organs or spine. Staph can also cause food poisoning and toxic shock syndrome.
Farron said she’d been putting in 15-hour days at the local hospital when she was struck. As a registered dietician, she was in charge of the innovative room service program. Farron was holding classes with nurses and staff to explain how it would work. Coincidentally, one of the most important issues was how to be vigilant about cleanliness so as not to spread Staph.
Farron told me she was walking her dog when she noticed a catch in her hip. A few days later, she went to church on Easter Sunday and sat in a pew. “I wanted to stand up, but I couldn’t.”
Her son drove her home and she faked the Easter cheer, looking for eggs and cooking a big dinner. There was no telltale boil or sore. She went to the doctor, who misdiagnosed the pain as a back problem. He recommended Tylenol, rest, and physical therapy. But just for Farron to get over there—a few miles away—she had to drive nearly standing up.
A few days later, in excruciating pain, she went into the emergency room, and was sent home without a diagnosis. Two more days went by and she simply could not walk. The pain was so bad she took 23 Tylenol tablets in the course of 24 hours, along with Ultracet, another medication for pain.
That night, she was home alone. She took her phone into her bedroom, a life-saving decision. An hour after getting into bed, the pain was unbearable. She called 9-1-1 and was sped to the emergency room, where she announced, “I am not leaving this time without a diagnosis.” They admitted her.
The next several days were a blur. The doctors suspected Staph and identified an abscess at the base of her spine. She was put on large doses of antibiotics and pain medication, but the pain was unrelenting.
Dr. Cilluffo, a neurosurgeon, was her savior, she said. Cillufo took control. He feared the infection was shutting down her spine and tested her skin sensitivity with a pin test. She couldn’t feel anything from the waist down. Cillufo called for an immediate operation, realizing the infection was encasing her spinal cord. He told her: “If we don’t do this operation, you’ll be wearing diapers and driving a motorized cart for the rest of your life.”
Dr. Cillufo made an incision to release the pressure from the abscess (this is often done for Staph). She spent the next four weeks in the hospital on heavy medication for pain. There were good moments, too, like the time her daughter drove most of the night from MSU, and climbed into bed with her to cuddle with her. “The memory just chokes me up,” she said.
When Farron came home, she had to put grenade balls of medicine into a port in her arm for another 30 days. She got better and eventually learned to walk again.
“Thank god for modern medicine,” Farron said.
Farron now looks 10 years younger than she did then. The only side effect from the antibiotics is a constant ringing in her ear, called tinnitus. She believes the Staph came from the hospital, but it just as well could have been from a cart at the grocery store through a torn cuticle. She wanted her story told so that others wouldn’t lose valuable time as she did with a misdiagnosis.
Three months after, another friend of mine, Robine Wright, was struck with Staph. She had undergone chemo and a mastectomy in February, and was getting some in-office plastic surgery done eight months later. (She wasn’t told that chemo increases chances of Staph.) A few days later, the nurse noticed a pink tinge around the stitched incision. She brushed it off.
That night, Wright went to a football game and had chills. She woke up on Saturday morning, feeling as if a steel lock was in her breast. She felt sick, but decided to run a 5K race anyway on a cool, rainy day. Deeply chilled, she warmed up in the bath and sent her husband out for cold medicine.
The next day, she tried to work, but knew she’d better get home. It took everything to get into the car and press the gas pedal. Once she was in the garage, the family had to move her on a chair. A neighbor, who was also a doctor, had been tracking her condition and prescribed some medicine. But at 4 p.m. he urged her to go to the emergency room. “By that point, I thought, I’m dying. I’m really dying.”
The Staph had moved to Wright’s leg, and it took two months to learn how to walk again, using first a walker, then a cane. Like Farron, she gave herself antibiotic grenades for several months in an arm port. Wright was lucky. She’s back running again with no pain.
I met another woman, Kim Lint, at a wild game dinner in the fall of 2005 just before she was struck with MRSA. Lint, a Mesick elementary school teacher had arthroscopic surgery on her knee on a Monday in November. The surgeon made three little pin holes and gave her an antibiotic during surgery to prevent a Staph infection. By Wednesday, the holes were “weeping,” but the nurse told Lint it wasn’t out of the ordinary. By Saturday, Lint felt flu-like and her leg blew up like a balloon, hot red, and tight. Apparently, the strongest bacteria had resisted the surgery antibiotic and rebounded with a vengeance.
By Sunday, Lint’s pain zipped from a “two “ to a “10” and she resisted the urge to check into the emergency room. By Monday, the pain was horrible and her surgeon sent her to Munson. She had to wait a day longer for a surgeon to relieve the abscess pressure. “The pain was so excruciating, I wanted to jump out the window,” she said.
Lint was given heavy doses of antibiotics and pain medication. She was discharged after a week, unable to walk. After about three weeks she felt better, but then her health took a downturn. She wasn’t eating, her fever soared and the pain came back. Her husband, Scott, insisted she go to the doctor. That’s when she was diagnosed with MRSA and put on vancomycin.
“I almost died. If Scott hadn’t taken such good care of me and insisted I go back to the doctor, it could have spread quickly. It can be a matter of hours, and it can get out of control and you can die,” she said.
Lint said her surgeon told her she probably contracted Staph from her knee surgery, since the infection was deep. She returned to school in February, still on crutches, and only ended physical therapy this past August, feeling she’d taken it as far as she could.
Her leg is deformed and she’ll always walk with a limp. In fact, she may carry the bacteria for the rest of her life. Her surgeon told her he wants to make sure the Staph is completely out of her system before he replaces her knees that are now rubbing bone on bone. Lint understands his caution. One of her friends contracted Staph during knee surgery, and got it again when the doctor opened up the knee to clean it out.
Lint cautions that any MRSA infection be taken very seriously, treated immediately and monitored closely.

SCHOOL POLICY
Should schools be closed when a MRSA case is discovered?
MRSA is not airborne, but can be transmitted by skin-to-skin contact or by contact with items that have come in contact with someone else’s infection, such as a phone, TV remote or work-out equipment.
The state is reporting at least 222 outbreaks of the MRSA strain, including one case in the Traverse City school district.There is no official outbreak in the district (an outbreak is defined as three cases that are linked).
The TCAPS district last week sent an email to parents, notifying them of the infection, and gave them guidelines to share with their kids, such as washing hands and not sharing items with schoolmates.
The Grand Traverse County Health Department does not collect statistics on Staph infections. Munson Medical Center does track Staph infections, but declined to release its numbers to Northern Express. The statistics are not straightforward, because Staph is only one of many factors that may cause death, said Dr. Karen Speirs, an infection specialist.
Munson does not screen everyone coming in for MRSA. In part, it’s because the screening policy would put more patients in isolation, which is expensive for patients and the hospital and may not be covered by insurance. Colonization that would be discovered by a screening culture may not even cause an infection, Speirs said.
The Illinois Legislature passed a law that everyone going into intensive care must be first screened for MRSA. New Jersey and Pennsylvania have passed similar laws.
“I anticipate getting to that point. We began a pilot study at Munson, two to three months ago, and screened everyone coming into the intensive care unit for four consecutive Mondays,” Dr. Speirs said. “We concluded that there’s a much lower number of MRSA carriers, so it supports that we do not have as much of a problem as we thought we had.”


Some basic guidelines
• Viruses, not bacteria, cause colds, flu, and most sore throats. So don’t pressure your doctor for antibiotics unless you have a bacterial infection.

• Bacteria does cause strep throat, which can be diagnosed with a throat culture.

• Viruses are behind most coughs and bronchitis. But if you’ve suffered for more than two weeks or have a respiratory condition, see a doctor.

• Sinus infections can be caused by bacteria or viruses. Infections that last more than two weeks are probably caused by bacteria.

• TV remotes and toilet handles are among the worst carriers of bacteria, especially in hospital rooms; at home keep them clean and disinfect periodically.

• But don’t over disinfect–studies show that if your house is too hygienic, your children will end up with a weaker immune system and a much greater chance of suffering from allergies, asthma, eczema, and hay fever.

• If you fail to take the full round of antibiotics as your doctor prescribes, beware. The “remaining” bacteria could trigger an even worse infection.

• You might want to choose regular soap and water for washing instead of antibacterial soap, which can destroy the good bacteria that help fight the bad.

• Eating live culture yogurt or probiotics containing acidophilus bacteria helps build up your body’s healthy bacteria—especially important after a round of antibiotics.

• Buy meat and eggs from farms that are antibiotic free. It supports farmers who rely on clean living conditions, not antibiotics, to keep animals healthy.

• Wash your hands before you prepare or eat food, treat a cut or tend to a sick person, or handle your contact lenses. Do the same after you use the bathroom, handle raw foods, change a diaper, blow your nose or sneeze, play with a pet or handle garbage.

• When you wash your hands, use soap and warm, running water, wash every bit of your hand, rub them together for at least 10 seconds, dry with a clean towel, and apply lotion to prevent drying and cracking.

• If your child is in sports remind them of the need to wipe down benches, weight bars, etc., and not to share equipment.

Source: Silver Colloids and Centers for Disease Control