Vanessa Carter is an international patient advocate for Antimicrobial Resistance (AMR). She has used her personal experience of AMR to help change the lives of others. Vanessa tells her compelling story to GARDP.

Could you briefly describe what led up to your multi-drug resistant infection?

I was a passenger in a serious car accident in Johannesburg when I was 25. I suffered massive injuries to my stomach, back, neck, pelvis and face. The most complicated injuries were to the right side of my face. It needed to be reconstructed with a step-by-step process that required different procedures and prosthetic implants to rebuild the bones, as they had been mostly obliterated on impact.

When did you realise you had developed a bacterial infection?

I had a series of operations on my face over the course of six years and started to form adhesions on the plastic prosthetic under my eyelid. One day I felt moisture on my face. I looked in the mirror, and to my horror, I saw pus seeping out of my face. I was admitted for emergency surgery to clean the prosthetic and work on the area which was now damaged by the infection. Two weeks later, the infection came back, but this time it was worse. I had more operations, but every time, the infection returned. This lasted for 11 months. Nothing seemed to work. Finally the plastic surgeon made the difficult decision to remove the prosthetic. I called the pathologist’s office and asked for a test. The result read: “MRSA — Methicillin-resistant Staphylococcus aureus” which is a type of bacteria resistant to several antibiotics. I googled MRSA and found out about antibiotic resistance – a term I had never heard about before. I was speechless. I had been on countless antibiotics and not once had I heard about it.

How did this make you feel on top of everything you had already gone through?

Totally surprised. I couldn’t understand why such an important issue like an antibiotic-resistant infection wasn’t common knowledge, especially as a high-risk patient who had undergone so many prosthetic surgeries and seen so many different doctors. It had never come up in conversation.

What was it like having an infection that lingered — and how did the doctors finally treat it?

Every facial surgery I went through I prayed was the last because day by day I would watch the infection slowly eating my face. I finally found a maxillofacial professor who cut the cheekbone to realign it. The result was brilliant. However, an infection returned, as well as an allergy to a topical antibiotic this time. His fear now was that the infection was in the bone. He started to rotate antibiotics. He also stressed how important it was to take my antibiotics religiously on time, at equal intervals. After the third month of doing this, the infection slowly started to disappear. I finally looked presentable enough to uncover my face. I had covered it for years with eye pads, glasses, you name it. Nine years after the accident, and thinking I would never beat this infection, that was like freedom day for me.

Why did you decide to become a patient advocate for AMR?

It bothered me tremendously that the term “antibiotic resistance” wasn’t common knowledge. When you think about something like cancer, one immediately associates potential causes like smoking or overexposure to the sun. Why wasn’t the same happening with antibiotic resistance? Why wasn’t I associating the overuse of antibiotics to the potential aggregator to my infection? I was totally ignorant. I wanted to change this situation by raising awareness about AMR and empowering patients to make informed decisions.

What can people do to slow down resistance?

It’s vital that you don’t take antibiotics for the wrong reasons. They were designed to kill bacteria so people shouldn’t be using them to treat viral infections, such as a cold or flu. We need to take antibiotics as prescribed and for the right duration otherwise we give bacteria a chance to mutate. We should never keep leftover antibiotics, or self-prescribe to ourselves or family members. Another way to prevent infections is to practise good hand hygiene, both in hospitals and in the community.

How important is it to develop new antibiotics?

We are running out of antibiotics that work. We haven’t invested in finding new ones, while the old ones are failing more by the day. The last time we developed a new class of antibiotics was in the late 1980s. Antibiotics are a precious resource. They save so many lives and we need to develop more of them.

From your experience, do you see AMR as a rising challenge?

It’s been a rising challenge for a long time, but it’s never had the attention it deserves in all sectors of health, from human to animal and environmental sectors. Cases where last-line antibiotics don’t work are on the rise and we are not being proactive enough about changing policies, raising awareness and investing in solutions to save lives.

Just like COVID-19, AMR doesn’t discriminate. It can happen to anyone, wherever you live. But we can all play a role in changing the situation.