Life threatening illness and sepsis after being induced in hospital. AIBU to wonder whether hygiene levels in this hospital could be to blame?

[Februaryblooms]

Induced by pessary on Saturday night due to reduced movements, DD(darling daughter)born Sunday morning. Vaginal delivery resulting in second degree perennial tear and stitches.

Multiple vaginal examinations since.

We were both fine until 24 hours later when I became extremely unwell on the ward, sepsis was suspected and I was placed on antibiotics and fluids before being moved from maternity to a HDU room on labour ward where sepsis was confirmed.

A blood culture was taken to find the type of bug that caused the sepsis and results returned today showing me as having streptococci A which is fatal for mums and babies if it enters the blood stream and can cause death. Basically the worst case scenario, I have it.

Awaiting DD's blood culture results but she's also on antibiotics as a precaution.

I'm in isolation and am being treat as highly infectious, and rightly so. I'm worried about the potential of other mums and babies becoming unwell so am plagued with guilt aswell as worry.

I appear to be responding well to antibiotics according to my OBS so I'm hoping I'm making my way out of the woods, I'm lucid and mobile, eating and drinking and don't 'look' like I'm about to drop anymore, but it's still a case of treat - wait - see.

Before being put into isolation i was speaking to the mum of a young woman who was induced here a day after me. This young woman also ended up having stitches then contracting sepsis and was awaiting the results of a culture to determine which 'bug' had caused it, however her symptoms areexactlythe same as mine.

AIBU(am I being unreasonable)to suspect for even a second that hygiene factors in the hospital could be to blame for what's happened to us?

I was the picture of health before I came in.

If relevant, the hospital is in a deprived area of London and some of the wards have seen better days.

Sorry for asking a stupid question, but could you have had it beforehand?

Take pictures of your notes if you can, you are probably still very ill right now. I'm so sorry this happened and hope you and your daughter are recovering well.

The actual ward cleanliness won't make a difference. It's possible that staff aren't practising good hand hygiene measures prior to examining stitches.

It's possible that it's just one of those things. Quite a few people carry strep A with or without symptoms. You could be a carrier yourself and not have symptoms, anyone who has a sore throat may have it, it's prevalent amongst young kids.

Do you have other children?

Strep A is also 'Strep throat' it lives in you.

Sepsis is just a scary word for blood poisoning,

You could have inadvertently touched your mouth, then any open wound, or even had a cut in your mouth.

DH developed sepsis from a dental filling, nothing to do with the surgery or its cleanliness.

I came out of hospital after my first with MRSA and at least one other bacterial infection in my episiotomy. I’ve always thought it was from a lack of hygiene by one of the many drs who involved themselves in my baby’s delivery.

Strep A organisms can be naturally occurring in your throat or on your skin. So it could have come from an individual examining you but also equally could have come for your own skin

A lot of people do carry strep A in their throats (if you have had a sore throat or an older child one thats quite likely a source of the infection - I know in the last maternal death enquiry all the mothers who died from strep A had an older child - kids aren't the best with hand hygiene and love to share germs)

It could be staff - however I remember having to be tested when two women developed strep A within 24 hours of each other - infection control were convinced there must be a link - and myself and one other member of staff were the common factor. They tested both of us - neither of us were the cause - they never found one, despite swabbing staff and equipment etc

So in short you aren't U to wonder if, but it would be to say that is definately the cause

You likely had Strep beforehand, a lot of people do.

Sepsis - people say blood poisoning - but it's your body's response to the infection. Your body goes into inflammatory mode, but in sepsis it overwhelms the body and makes you very ill. Your cells can't metabolise properly. Your blood ends up more acidic..

To be honest we over-diagnose sepsis because of the screening tools we have to use

I do have an older child, he's 15 months. My DM is caring for him whilst I'm in the hospital and she says he is fine with no temperature or sore throat.

I didn't notice anything wrong with him before I came in either.

My OH was unwell with some viral type virus a few weeks prior but that's all I can think of in terms of picking it up from somebody being under the weather.

I hope you are feeling better and your baby is doing well. You can ask to speak to the microbiologist or infection control nurse with your concerns. Sometimes it's almost impossible to find the cause of infections.

Doctor came to ask my permission for my contact details to be passed on to a microbiologist outside this hospital for some reason, I'm presuming because they're concerned about the source of the infection on the basis that we just don't know where it's come from at the moment.

I've OK'd that and will see what they say or ask me if they call.

Do they have a microbiology dept at the hospital? they look at the bacteria and what are the right treatments to give.

I presume they have a microbiology lab here but that's just a guess on my part as I don't have the first clue to be truthful. I will ask.

The doctor did say that the specific person he wanted to pass my contact details on to wasn't based in this hospital.

My antibiotics have been adapted following my diagnosis of strep A. When the culture results came back this morning a new antibiotic was introduced to my treatment plan. I assumed this was all handled within this hospital but perhaps not?

I do have an older child, he's 15 months. My DM is caring for him whilst I'm in the hospital and she says he is fine with no temperature or sore throat

You or he wouldn't necessarily be unwell with having strep A in your throat at home. We carry a lot of bacteria in our throat, our skin, our gut, some potentially harmful, which often cause no problem, they quietly live there. But a minority of people get sick from them, particularly if the bacteria gets into your bloodstream somehow. This bacteria could have been quietly living in your body for years.

I came out of hospital after my first with MRSA

Were you swabbed for mrsa before you went in? You may have had it quietly living on your skin for years if not.

Some hospitals don't have a microbiology, we don't, we have to use the neighbouring hospital OP. That might be why

I wouldn’t panic too much, appreciate it’s easier said that done. If you were really in a life threatening state, you’d be in intensive care and much more unwell that you’ve said in your posts, probably too unwell to pick up a phone and post in a sensible, coherent manner. I’m not saying you’re not really poorly or belittling your - understandable - anxiety and illness but trying to give a calming, outsider perspective. Wish you a speedy recovery.

Details being passed to someone outside the hospital is probably public health. All invasive Grp A Strep infections are notifiable to public health.

Generally speaking, with infections, the rule is that if you have symptoms of the infection within 48 hours of admission, it's community acquired. If your symptoms occur after 48 hours from admission, it's hospital acquired.

If you were induced on Saturday night, then your 48 hours wouldn't be up until the Monday night. From my reading of your timeline, you gave birth on Sunday morning, then fell ill on Monday morning? That's 36+ hours after admission, so would be deemed 'community acquired' (so not from within the hospital).

However, that may be just as I read it. Your treating team will know best how to manage your care.

'Broad spectrum' antibiotics are initially used to combat sepsis - there isn't time to wait for an accurate diagnosis. Once the cause of the sepsis is known, then specific antibiotics can be used.

To reiterate in case anyone missed it: you can't catch sepsis. You get an infection & sepsis is your body's inflammatory response to that infection.
I hope you recover soon & are able to get home.

All aboard the bus!

All aboard the bus!
Eh?