Shouldering pain of superbug

Bill Aylward holds one of the many artificial shoulder joints he has had and lost due to superbug infections after operations on his left shoulder. Photo / Steven McNicholl

Bill Aylward, a veteran of 26 hospital admissions in five years and a string of failed shoulder-replacement operations, knows the misery that superbug infections can inflict.

He suffered badly from a series of major infections, including an ESBL superbug bacterium, that led to the repeated operations on his left shoulder at Middlemore Hospital in South Auckland. The 71-year-old from Clarks Beach, near Waiuku, spoke out after reading in the Herald this week of the extended-spectrum beta-lactamase bacteria outbreak for most of last year in a Middlemore ward.

He was certain he caught ESBL at Middlemore and said it was because of the hospital's poor hygiene.

But Middlemore spokeswoman Lauren Young said yesterday that cleaning had been greatly increased by bringing it "in-house" in 2008, instead of it being done by a contractor. This had reduced infections.

She added that superbugs were an unfortunate fact of life in most modern hospitals. Few worldwide had managed to rid themselves of superbugs once they were established. Only Scandinavia had had any success.

Ms Young said it was "fully accepted" Mr Aylward could have been infected with ESBL at Middlemore, but the high doses of antibiotics he was on for a long period could also have contributed to his contracting it elsewhere.

ESBL-producing bacteria are a group of bugs that make enzymes that can destroy various antibiotics, making them difficult to treat. In most affected patients they harmlessly "colonise" the bowel, but in some they cause serious infections, particularly if they cross into the blood. They are potentially fatal.

Mr Aylward had left shoulder surgery in 2004 at Mercy Hospital to implant an artificial joint because of osteoarthritis. He had previously had the same operation on his right shoulder and it has remained "perfect".

He developed a problem on his back which was at first thought to be melanoma but later proved to be an infection with the bacteria staphylococcus aureus.

He underwent investigations at Auckland City Hospital before being treated at Middlemore from 2007.

He had two infections from staph aureus and one from a fungus.

ESBL was diagnosed in 2008.

He was treated with intravenous antibiotics and other medicines.

The infections invaded the shoulder and sometimes spread widely through his body. The prosthetic joint had to be replaced by a new one, but this, too, became infected, leading to more replacements and procedures to cut away diseased tissue.

The infections, medicines and operations made him feel dreadful.

"Twice I was so crook I wished there was some way that when they were removing the infected bit, that I wouldn't wake up."

"The ESBL was the most painful of the lot. The joint swelled horrendously. A couple of times the wound burst open."

"I ended up with 40 weeks in hospital, 26 admissions over a five-year period, 12 major procedures, innumerable minor procedures, lots of different antibiotics - and I've lived to tell the tale."

A grandfather, he's glad he has survived: "I was hugely optimistic, because I had things to do, and still have."

Mr Aylward has lost count of the number of left shoulder joint replacements he has had - eight or nine.

It is 15 months since he recovered from his last infection, but his current left shoulder joint has failed.

He goes into hospital on Monday for a pre-admission assessment for surgery to remove the joint and possibly replace it with just a ceramic "spacer".

This will leave Mr Aylward - who has received a payout from ACC for treatment injury but declined to say how much - with an arm with little function, as it is now, although the hand should retain the ability to grip.