Vanessa Carter - e-Patient Scholar Antibiotic Resistance

Editor's Notes

1. I don’t remember the accident in 2004, I only remember waking up to a white ceiling,
2. Unable to move, heavily drugged, having fits and hearing machines pump air into my lungs. I’d suffered massive injuries to my abdomen and face. When I finally worked up the courage to look in the mirror, I saw a mess.
3. My face needed to be reconstructed with different types of super-specialists. Each of them were tissue specific, so, the maxillofacial surgeon worked on the bone, plastic surgeon on the skin, ENT on my sinuses, ophthalmologist on eyes and neurosurgeon with nerves. Their advice overlapped which confused me and I found myself in tears trying to co-ordinate care between them. For seven years my surgeries were failing.
4. In 2011, we implanted my fourth facial prosthetic and a few weeks later I developed an infection. Every day I watched a bacterial discharge eat the flesh off my face. I underwent multiple debridement surgeries and heavy doses of antibiotics to try clear the infection, but it kept coming back worse. Almost 11 months passed and I hardly had a face left. In a final emergency the prosthetic was removed.
5. It was riddled with MRSA, a fatal superbug called Methicillin-resistant Staphylococcus Aureus, which was resistant to Penicillin antibiotics. Four months later and a course of a different antibiotic called Vancomycin the infection disappeared.
6. I couldn’t explain where MRSA came from, but I knew I couldn’t rely on Penicillin to get me through more surgeries. During those 7 years, I’d been through a medical-legal trial which accumulated 53 doctors’ reports. I summarised them into four-pages, searched the web for the best doctors in the world and pleaded for help.
7. One day, a face transplant surgeon called Dr. Edward Caterson in Boston working on cases like mine was willing to offer a video call. He explained what I needed to do in as few surgeries as possible and armed with his advice, I found South African doctors who could perform them.
8. After a mere eight months, two surgeries and a third antibiotic called Clindamycin, my face was finally fixed.
9. Since MRSA, I’ve done whatever I can to understand antibiotic resistance. Bacteria were one of the first life-forms on earth and there are trillions of species around us. Some strains of Bacteria even exist in our body as part of an ecosystem called our microbiome and when they are exposed to threatening environments, like too many antibiotics over a long period of time, they can adapt to survive.
10. Staphylococcus is a species of bacteria that lives mainly on our skin and noses, even on healthy people, but if they enter our body through a wound or respiratory tract, they can cause infections like Pneumonia or Sepsis.
11. More than 30 different strains of Staphylococci can cause infections, but the most common strain is Staphylococcus Aureus. In 1928, a scientist called Sir. Alexander Flemming discovered Penicillin which could kill the Aureus strain and today it’s our most common antibiotic, however, in 1961, scientists discovered the first patient carrying a Penicillin-resistant mutation and called it MRSA.
12. In 2016, The World Health Organisation reported that antibiotic resistance had become one of the biggest threats to global health and that we need harmonised, multi-sectoral systems to tackle it. About 700,000 people worldwide die annually due to drug-resistant bacteria and by 2050, that could rise to 10 million, which is more than Cancer.
13. The biggest cause of MRSA is the overuse and incorrect use of antibiotics, but it can also be acquired in hospitals, spread in public places through skin-to-skin contact or from contaminated surfaces and objects.
14. We overuse antibiotics in our pets and in the meat we eat. Multi-Drug Resistant strains of bacteria also affect diseases like TB, HIV/AIDS and Malaria. The global population is rising along with the overuse of antibiotics that are causing mutated strains of bacteria like MRSA. The same antibiotics you give your child for an ear infection, use after surgery or rely on to save your life will become useless, if we don’t stop squandering them.
15. We must promote proper use of antibiotics more aggressively, not only in human and animal health but in food safety too. Patients need to be informed about the risks of overexposure to antibiotics and understand when they are appropriate so they don’t self-medicate for the wrong conditions like flu or put pressure on their doctor to prescribe antibiotics for minor infections that can be treated with alternatives.
16. Infection prevention must also be strengthened by teaching the public about good hygiene to reduce the spread of germs.
17. Travelling citizens must understand how bacteria is spreading across our borders. There are no new antibiotics on the way either, so we have to improve solutions like digital tools that help us collect data to understand the mechanisms of bacterial resistance.
18. Just like climate change, antibiotic resistance is a threat to every one of us globally, and if we don’t take action against it together now as human beings living in one world, their microbial world will win.