Man loses leg to superbug after routine knee replacement

In a shocking incident, a 68 years old British man who had undergone a routine knee replacement has had his leg amputated after contracting a superbug infection.

Anti-microbial resistance (AMR) is becoming an increasingly urgent challenge globally.Theinappropriate prescription of antibiotics is a contributing factor to the rise of superbugs.The horrible case is of Paul Tilley, a former catering manager from Dalton in North Yorkshire, who had his right leg removed before Christmas. He had contracted the bug after a simple knee replacement.

Despite doctors rigorous effort to combat the infection over the course of six years and a series of follow-up operations, they were not able to avoid the leg amputation.

Data suggested there are at least 2000 superbug-related deaths in the UK each year, many linked to common but invasive operations such as hip and knee replacements

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“The doctors don’t tell you, you need a leg amputation – you have to take the decision yourself. But after six years of pain and not being able to live my life it was the only choice,” said Tilley.

Mr. Tilley problems began almost as soon as his knee was replaced. His medical notes showed a series of infections set in, including the superbugs meticillin-resistant Staphylococcus aureus (MRSA) and Enterobacter cloacae. He received a wide range of antibiotics and endured three follow-up knee replacements but the infections could not be killed off. Surgeons even tried an artificial knee coated in silver, a metal known for its anti-bacterial properties.

“Within a matter of days, I was in the most tremendous pain. I was shaking and vomiting. The nurses had to call the surgeon out in the middle of the night because they didn’t know what to do with me,” he said.

Mr. Tilley said last week he had never heard of superbugs or antibiotic resistance before his first operation. Now he has become an expert, losing track of the number of different antibiotics he has taken orally and by drip over the last few years.

“It’s like a row of soldiers. You knock one infection down but then another one pops up. You go home and you feel okay but then it’s all hiding there underneath the skin.

“It starts off as a little pimple or a red spot and then the skin turns black and gets swollen and incredibly painful,” he says.

The pain of the infection was the worst thing, said Mr. Tilley. It was so intense during a walking holiday in Spain he considered throwing himself off a mountain path. In the end, he opted to have his leg amputated.

“Between the microbiologist and the surgeon you could see they were fighting their way through this. They didn’t know what to do with me. There are no antibiotics for this-this is the end of the line,” he said.

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“If you look at the figures on knee replacements about two percent become infected – it’s a bit higher for the second knee and a bit higher for the third knee.

“The more operations a patient has there are less and less bone and soft tissue for the surgeon to work with so the replacements become that much more difficult,” he said.

When bone becomes infected you need to get high concentrations of antibiotics into it and not all oral antibiotics achieve that. And if you have a resistant organism it becomes harder because you have a limited number of options. The infections are treatable but you don’t have as many choices and you end up relying on drugs from the 1950s and 60s,” he says.

What Mr. Tilley has gone through is still rare, says Dr. Williams, but resistant infections are not. The numbers are going up and up. There’s a straight correlation between the number of antibiotics we use and the number of resistant infections,” he says.

Mr. Tilley underwent the amputation in November and nearly two months later his stump is healing well and he is looking forward to having a prosthesis fitted in the next few months.

He says adjusting to life as an amputee will be hard but once he gets the hang of his prosthesis he hopes to be back to his previous, active self.

Cases of antibiotics resistant are on the upsurge in last decade. Officials estimate that at the current rate, 10 million people a year will die worldwide by 2050 because of the rise of superbugs.