Oct 28, 2007 - 04:05:35 CDT
Both of Laura Giardini's feet are bandaged. It was her right foot that brought her into the emergency room about two weeks ago."I assumed it was a sore or blister from my diabetes," she said.
The Mandan woman went to the emergency room when she noticed blood dripping in her shoe. Doctors tested the wound on her foot, and discovered it was methicillin resistant staphylococcus aureus, or MRSA. This is the same type of infection that has closed a number of schools on the East Coast because students and staff were infected.
Recently, more people have been coming to U.S. hospitals and doctors offices with a form of the infection that they picked up outside a hospital setting, which is where most staph infections occur. According to the Centers for Disease Control, 84 percent of people with MRSA had the infection because of contact with a health care setting, and 14 percent had an infection without such a contact. In 2005, about 94,360 people had MRSAinfections in the United States.
Giardini's infection was advanced and could have been fatal if she waited any longer to seek medical treatment, infectious disease physician Dr. Kent Martin at Medcenter One said. Usually when people have a drug-resistant staph infection, they have something that looks like a spider bite. Sometimes, it becomes pus-filled and will not heal.
"All I knew (about MRSA), I read in Reader's Digest a couple of months ago," she said. "I told my family I seemed to have the 'superbug.'"
She had forgotten one of her grandsons had a similar infection 10 years ago when he was a teenager.
The MRSA form of staph is resistant to methicillin and other types of penicillin, which are commonly used antibiotics. When doctors get patients who have MRSA, they use one of four intravenous antibiotics. There are rare cases of the bacteria forming a resistance to one of these drugs, Martin said.
The seriousness of the infection on Giardini's foot, which she couldn't feel because of diabetes, caused doctors at Medcenter One to bandage the other foot as a precaution, in case it spread.
"If I had what she did, I would have been screaming," said Jeannie Baier, Giardini's daughter. The skin was gone, she said.
Giardini is unique, in that she doesn't feel any pain from the wound, Martin said.
"Most people, it hurts and it's painful," he said.
Drug-resistant staph is a form of the common staph bacteria, and it lives in people's noses, Martin said.
"One or two people in this room probably have it in their nose," he said about common staph. He was in a room with six other people. "You will have it a little while, and it will go away. When it is exposed to antibiotics, it develops a resistance."
While the bacteria lives in the nose, it becomes a skin infection by getting on the hands or under the fingernails and imbedded under the skin when a person scratches. It spreads to different locations when a person touches other surfaces.
Usually it can be traced to people who work in close contact with large groups of people or in a health care setting. For example, a daycare worker or hospital employee can be carrying it, touch a door knob at home or a shopping cart at the grocery store, and then someone else gets it by touching the door knob or shopping cart, Martin said.
Not everyone who touches the tainted object will get MRSA and need to be hospitalized. Baier, who lives in Bismarck, has not shown signs of an infection, although she has had close contact with her mother prior to her hospitalization. She helped her mother prior to going to the hospital, including changing her bandages, and has helped clean her house since she's been in the hospital.
Baier takes precautions against getting an infection by wearing a disposable gown and gloves when she visits; then when she's home, she washes her clothes, cleans the soles of her shoes with disposable cleaning wipes and washes her face.
"I'm very careful before Iget home and sit around," she said. "I don't want to give it to my husband."
The steps Baier is taking after visits with her mother are good ones, Martin said.
The family also decided some relatives would not visit Giardini while she's in the hospital. Great-grandchildren and their mothers do not visit, just in case, Baier said.
It takes about two weeks to treat a skin staph infection. If it gets into the blood stream and doesn't affect organs, it takes four weeks to treat. If it affects the heart valves, it takes six weeks, and if it affects any organs, it takes four to six weeks to treat, Martin said.
"Most people do recover," Martin said. "The death rate is still low, but we have disturbing deaths; young people, who seem to be healthy get a bad infection and die."
(Reach reporter Sara Kincaid at 250-8251 or sara.kincaid@bismarcktribune.com.)
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