Antibiotic-Resistant Bacteria Cause Unhappy Events

A few years ago, the son of a Pediatric Working Group member was admitted to the hospital for an infection of the skin around his eye (otic cellulitis) caused by the bacteria staphylococcus aureus. In the hospital the little boy was given IV antibiotics for three days and the skin infection went away without hurting the eye. Everything seemed fine.

Eighteen days later the otic cellulitis came back, caused this time by a different bacteria: pseudomonas aeruginosa. This is an all-purpose infecting agent, it can attack many areas of the body, causing infections of the lungs, blood, skin and skin-structure, urinary tract, bones, joints and the central nervous system. This bacteria is one of those that don't bother the general population much but which can be pretty troublesome for the immunocompromised.

Again, the cellulitis was treated with a few days of IV antibiotics and voila! Another apparent success. Unfortunately, the bacteria was antibiotic-resistant and the stronger organisms lived on in the child's body even though the second cellulitis looked to be as cured as the first had been.

Several weeks passed. The little boy began to complain about his throat, a fever started. The resistant bacteria had lodged in the soft tissue of the little boy's throat. His immune system was too weak to contain the infection so the bacteria's effect spread all around his neck. The infection caused his throat to swell so greatly that his airway started to close. He ended up in the ICU on a respirator for 8 days. He nearly died.

The last course of treatment required that two of the strongest antimicrobials be given intravenously for six weeks in order to be sure that all the antibiotic-resistant pseudomonas was finally killed.

The little boy has recovered, but the tissue of his throat was badly damaged. It took a very long time for him to be able to swallow properly or speak clearly.

Did the antibiotics used to treat the original staph infection change the balance of the normal bacteria in the boy's throat (killing those sensitive to the antibiotics but leaving resistant bacteria behind), or was the resistant pseudomonas picked up in the hospital? We can't know the answer, but we can try to minimize the chance of such a thing happening again:

1. Wash your hands, make the kids wash hands, be sure healthcare workers wash hands.

2. Do not use or ask doctors for unnecessary antibiotics.

3. Finish every bit of a prescription for any antibiotic.