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.

8 Comments

1. 1. Drisin 01:34 AM 12/1/07

   You might want to learn about NovaBay pharmaceuticals. They have a new compound that kills MRSA on compact. Phase two trials should be finished in Jan. 2008

   Reply | Report Abuse | Link to this

2. 2. D'Anne 04:42 AM 12/7/07

   The really sad thing here is that had this woman been at home with a good midwife she would have had neither the c-sec nor MRSA.

   Reply | Report Abuse | Link to this

3. 3. mgoulet 06:59 PM 1/1/08

   This article is very timely given the crowding conditions that hospitals are faced with. With occupancy levels higher than capacity strains all resources including the ability to ensure infection control practices are consistently applied.

   Reply | Report Abuse | Link to this

4. 4. hongkeeong 08:02 AM 1/2/08

   Look like we have to design the hospital similar to standard of bio-hazard facilities. Compartmentalisation, negative pressure and UV light need to be introduced for the bacteria spreading wards.

   Reply | Report Abuse | Link to this

5. 5. John_Toradze 02:06 PM 8/27/08

   An article like this that does not discuss Ewald's work is not credible, it's just "Oh, gosh. Oh, golly." Ewald showed that M.D.s were THE primary vector for MRSA, the most frequent violators of handwashing protocols, and that resistance can evolve in a closed hospital setting in 6 weeks. He showed that opening up the system to competition from staph from outside will improve effectiveness of antibiotics and lower incidence of such infections. The response of the hospitals was to bar him from entry to their facilities, most likely due to an attempt to avoid legal liability in a malpractice scandal. The response from the medical profession responsible for curricula has been to continue to teach disproven theories that are now as out of date as those prior to Lister. Dr. Ewald has continued his fight and is now faculty in Kentucky.
   
   See:
   Ewald, Paul W. Evolution of Infectious Disease (Oxford University Press, New York, 1996). http://www.amazon.com/Evolution-Infectious-Disease-Paul-Ewald/dp/0195111397
   

   Reply | Report Abuse | Link to this

6. 6. Chase99 07:23 PM 10/9/09

   Okay, folks. Likewise, I was unable to dialate so I had to have a c section. One day after the surgery I came down with a horrible fever.....one that almost cost my life. turned out I contracted E COLI in blood and urine. While my son was in NICU...the doctors were attempting to cook the right dose of drugs to give to me via PIC line. I left the hospital 7 days later where my husband had to administer IV drugs from home. The whole experience was HORRIBLE. I'm having such a rough time trying to get over it....so many things I should have questioned and asked more questions of while I was in the hospital. I'm now responsible for several bills, total to approx 9000.00. (Even with Health Insurance) O and get this, the hospital has decided to "comp" my bills from Infectious disease...and other bills. However, I'm still responsible for other bills they didn't take care of or bills that the insurance company wouldn't pay due to hospital germs. I can't find a lawyer in town that will take our case and I feel TAKEN ADVANTAGE OF and there isn't a darn thing I can do about this. Bottom line, the hospital gave me an infection that nearly killed me. UGH

   Reply | Report Abuse | Link to this

7. 7. Chase99 07:27 PM 10/9/09

   Had c section, contracted E coli from hospital. So sick that it nearly killed me...wasn't able to bond with baby. Sent home with PICC line to administer for 2hrs a day for 7 weeks. I'm now responsible for several bills including Infectious Disease...BUT when I contacted hospital...they decided it would be wise to open investigation where they found they COULD have infected me. They are now comping my co pays and other bills...BUT I'm still stuck with bills that the insurance company won't cover or that they are not willing to cover. Are they admitting guilt here? Not to mention the fact that I can't find legal representation anywhere....I would think this would be cut and dry?

   Reply | Report Abuse | Link to this

8. 8. Jean 01:34 PM 12/30/11

   There is an ozone and hydrogen product callee AsepticSure which is being developed for distribution. It is a mist that fills the room and sterilizes everything without toxic residue. Interestingly it is probably also the one known cure for bedbugs. They cannot survive it either.
   
   Before long it will be standard in every hopital that wants accreditation.

   Reply | Report Abuse | Link to this