Vanessa's long journey with a drug resistant infection

Vanessa Carter doesn’t remember the Johannesburg car accident in 2004 that caused her life-threatening injuries, but she does remember its aftermath – the extraordinary pain while in hospital recovery, the extensive operations endured over ten years as a part of her facial reconstruction surgery; and how a drug resistant Methicillin-resistant Staphylococcus aureus (MRSA) infection contracted after one of those surgeries wreaked havoc on her life.

Vanessa sustained severe injuries to her abdomen and face in the car accident including a broken nose, a smashed cheekbone and eye socket, loss of her right eye, a broken jaw and massive facial lacerations. She also sustained neck and back injuries as well as a fractured pelvic bone.

Her hospital recovery took over a month, and even after being discharged, her journey to full health was far from over. Vanessa then required extensive facial reconstruction surgery and a team of clinical specialists was needed for each specific part of the reconstruction - a maxillofacial surgeon to work on repairing the bones, a plastic surgeon for the skin, an ear, nose and throat specialist for her sinuses, an ophthalmologist to work on her eyes and a neurosurgeon to work on the nerves.

A few weeks after Vanessa’s fourth facial prosthetic was implanted, she suddenly felt a wetness seeping down the side of her face. When she removed her eye pad and looked in a mirror, she saw bacterial discharge caused by an infection she had developed after the implantation. She went through several debridement surgeries to remove tissue from the damaged and infected areas and was placed on heavy doses of antibiotics, but the infection kept returning.

Every day, the infection continued to eat away the skin from the side of her face, leaving Vanessa terrified as her skin became thinner and weaker each day. Eventually her plastic surgeon recommended emergency surgery to remove the facial prosthetic and sent it to be tested. It came back positive for MRSA, a type of drug resistant bacteria that stopped responding to penicillin antibiotics.

We use antibiotics throughout our lives - they are medicines used to treat bacterial infections. Antibiotic resistance, also called drug resistance, occurs when bacteria change in response to the use of these medicines and stop responding to the antibiotics previously used to treat them. Bacteria, not humans or animals, become antibiotic resistant and it can affect anyone, of any age, in any country.

Antibiotic resistance is a phenomenon that occurs naturally, but the misuse and overuse of antibiotics in human and animal health are accelerating the process. Antibiotics form the cornerstone of modern medicine, and without effective antibiotics for prevention and treatment of infections, major medical procedures from chemotherapy to Caesarean sections become incredibly risky, if not impossible. Antibiotic resistant infections also come with higher medical costs and longer hospital stays since they are harder to treat than infections caused by non-resistant bacteria.  A growing list of infections – such as pneumonia, tuberculosis, bloodstream infections, gonorrhoea, and foodborne diseases – are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.

MRSA, the drug resistant form of the S. aureus bacteria that Vanessa had contracted, is widespread and a common cause of severe infections in health facilities and the community in every region of the world. People with MRSA infection are estimated to be 64% more likely to die than people with a non-resistant form of the infection.

After her infected facial implant was removed and she received treatment for MRSA infection, Vanessa sought guidance from a world-renowned transplant surgeon in Boston who provided her with a treatment plan for her condition in as few surgeries as possible. She was then referred to South African doctors who could perform the necessary procedures, and after eight months, two surgeries and a third course of antibiotic called Clindamycin, her decade long fight to complete her facial reconstruction was finished.  

Throughout her years of surgeries and setbacks, Vanessa was still balancing her advertising business and raising two kids. Inspired by the positivity and strength of her personal idols such as Stephen Hawking, she was adamant that her medical obstacles wouldn’t stop her from accomplishing her goals or living her life.

Vanessa emerged as an AMR survivor and fierce patient advocate with a strong desire to raise awareness and educate the public on AMR. She currently serves as a Facial Difference and Antibiotic Resistance Stanford University Medicine X e-Patient Scholar, an e-Patient is an individual who is equipped, enabled, empowered and engaged in their health and health care decisions, and encourages others to do the same. Vanessa is also the founder of hcsmSA (Healthcare Communications and Social Media South Africa) -- “#hcsmSA” is a Twitter chat she moderates to discuss Sustainable Health Development (#SDG3) and also provides training to stakeholders, including medical professionals, on effective use of social media and information about e-Patients. She is also an advising e-Patient to the South African Antibiotic Stewardship Program (SAASP) and ASPIRES (Antibiotic use across Surgical Pathways - Investigating, Redesigning and Evaluating Systems Research Collaborative).

“To this day, I believe that if antibiotic resistance had been common knowledge to me, in a similar way that I know applying sunscreen can reduce the chance of cancer, I might have asked one of my doctors for a diagnostic test sooner.” 

Vanessa's life-threatening injuries sustained due to her 2004 car accident.

An MRSA infection ate away the skin from the side of her face.