A woman whose health deteriorated after giving birth later tested positive for antibiotic-resistant bacteria that's increasingly common in New Zealand.
The mother-of-two became increasingly unwell - suffering excruciating pain when breastfeeding as well as cold sweats and chills - and found out she had Methicillin-resistant Staphylococcus aureus (MRSA) after going to her GP for swabs.
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She gave birth by emergency C-section at Auckland City Hospital in May and during level 3 Covid-19 restrictions, and for a few days recovered well. However, she then became unwell and more than two weeks later received confirmation of MRSA infection.
Following a change of antibiotics her condition has improved but her wound hasn't healed and she's not 100 per cent.
MRSA infection is caused by staph bacteria that's become resistant to some antibiotics, and is sometimes called a "super bug" because it's harder to treat.
Some strains are more harmful, but most can be treated with certain antibiotics. However, if undetected or treated infection can become serious or even life-threatening.
The woman, who asked to remain anonymous, said she initially dismissed the difficulty breastfeeding and cold sweats and occasional chills as owing to sleep deprivation, and a midwife suggested tongue-tie. But she felt worse and worse.
"I just drove myself crazy - have I forgotten how to breastfeed? In the middle of the night I'd be Googling how to latch properly.
"I reached the point where I thought it must be a bacteria infection or yeast infection. It was me going, 'This is not right, I'm going to the GP'. Luckily I've got a really good relationship with my GP ... I worry about other people who don't have support."
The swabs confirmed MRSA on her nipples and C-section incision. By that stage her health had worsened alarmingly, but the new antibiotics began to work after a couple of days.
About 30 per cent of healthy adults have staph bacteria living harmlessly on their skin, usually in places like the nose and armpits. Babies sometimes carry the bacteria in their mouths, without this causing health issues.
Infection may happen if the bacteria gets into the body when skin becomes broken or cut, including by a wound, surgical incision, feeding tubes or drips, and sometimes breastfeeding.
The woman wanted to speak out to ensure other mothers in a similar situation didn't ignore their pain and symptoms, or write them off as an expected part of breast feeding or their recovery. She also worried she'd picked up the infection in hospital.
Auckland DHB director of women's health Dr Rob Sherwin said it wasn't possible to confirm if that was the case, "but in New Zealand this is nearly always a community-acquired disease".
Infection control was taken very seriously, he said, with strict protocols including around hand hygiene.
"We help prevent the risk of infection after a woman gives birth via C-section by using skin antisepsis during the operation, good surgical wound care and antibiotics. Unfortunately, the MRSA strain ... is resistant to most antibiotics and requires a very strong type, which should only be taken if MRSA is confirmed as being present.
"If we suspect a patient has a bacterial infection while in hospital, we test to see what type of bacteria this is. If MRSA is identified, the clinical team is notified promptly so they can ensure the patient is given the correct course of antibiotics."
University of Auckland microbiologist Dr Siouxsie Wiles, author of Antibiotic Resistance: the end of modern medicine?, said there were very high rates of staph infections in NZ, compared to other countries like Australia and the UK.
The high rates and frequent use of fusidic-acid (an antibiotic) containing creams to treat infections meant MRSA strains had spread.
"Many people here have these bacteria living in their noses or on their skin or in their guts so it's much more likely the woman got this bug either from herself or from someone she knows rather than the hospital."
It was worrying that, given the woman's symptoms, midwives apparently didn't suspect infection, Wiles said.
Antibiotic resistance has been a health issue for more than 50 years but has grown to the extent that scientists have warned of an "antibiotic apocalypse" that will mean common infections become untreatable.
Globally, about 700,000 people die each year because of drug-resistant infections. The World Health Organisation estimates that could reach 10 million by 2050, if current trends continue.
Properly used, antibiotics destroy disease-causing bacteria. But if taken for a viral infection like a cold, drugs won't attack viruses causing sickness and instead destroy a wide variety of other bacteria. Those that survive this onslaught can multiply and spread, and share drug-resistant traits with other bacteria.
In New Zealand, prescriptions of some antibiotics surge by nearly 40 per cent in winter, indicating incorrect prescribing for colds and flu.
MRSA contributed to the death of infants and children during last year's Samoan measles epidemic, Ministry of Foreign Affairs and Trade (Mfat) documents obtained by the Weekend Herald detail. The leading cause of death at one hospital was pneumonia complicated by MRSA infections.
An internal report by Auckland DHB shortly before the measles outbreak warned antibiotic-resistant germs were endemic in some hospitals in the Pacific Islands, and travel and patient transfer could hasten the spread to New Zealand.
Resistant bacteria were emerging and spreading around the world, it warned, "threatening our ability to treat common infectious diseases, resulting in prolonged illness, disability, and death".
"Our most vulnerable patients will be at greatest risk - neonates, patients requiring intensive care and highly immunosuppresed patients," the DHB report, put to the board behind closed doors, warned.