Surviving a deadly combination of sepsis and multidrug-resistant infections
My name is Leticia Batista. I’m 28 years old and was born in Franca, a city in the state of São Paulo, Brazil. I graduated as a Physical Therapist in 2016 and moved to São Paulo in 2017 to work in a public hospital (Unified Health System – SUS).
In February 2018, at 22 years old, I was admitted to hospital. A few days earlier my symptoms consisted of a fever, sore throat, and runny nose. A day or two later my condition deteriorated. I started vomiting and went to the same hospital where I worked. In a few minutes, I was taken to the emergency department. I was diagnosed with community-acquired pneumonia (Streptococcus pyogenes). I had never been hospitalised, nor did I have any previous health issues. Soon I had septic shock due to a resistant infection. My family were in another city at the time, so without them immediately by my side in hospital, I was utterly terrified.
My blood pressure was very low. I had an unsuccessful intravascular expansion. In lay terms, intravascular expansion means adding more fluid into the bloodstream. This can be done by giving someone fluids through an IV to help increase their blood volume, which is important in situations like dehydration or significant blood loss to ensure the body has enough fluid to keep blood pressure stable and organs functioning properly. I also had a decreased level of consciousness. I was intubated and then transferred to the intensive care unit (ICU).
I spent 27 days in the ICU and had many complications such as acute respiratory distress syndrome, acute kidney injury (hemodialysis), and critical illness polyneuropathy. I also received blood transfusions and cardioversion five times for ventricular tachycardia.
Discharged with a ray of hope, but the journey wasn’t over
After discharge from the ICU and transfer to a general ward, I discovered a second lung infection caused by Klebsiella pneumoniae carbapenemase (KPC) and Pseudomonas aeruginosa. Because of that, I had more complications (pleural effusion) and spent another 35 days in the hospital. I needed to start a new course of antibiotics and have a chest drain put in. The bacteria were multidrug-resistant and sensitive to only one antibiotic, which was not in stock at the hospital. Thanks to a Facebook® campaign, I got the antibiotic on the same day. I also submitted a complaint to the hospital ombudsman and in about 2 days the antibiotic was available. After discharge, I donated the leftover antibiotics I had received through Facebook®.
After 62 days of hospitalisation, I was finally discharged, but the challenges continued. It took me a year to go back to work because of my physical capabilities and cardiopulmonary recovery. Six months after discharge, I had one readmission due to a repeat pneumonia infection (6 days hospitalised). I also developed a lot of anxiety, especially after the onset of COVID-19, the following year.
A miraculous recovery
Today, six years later, I feel like I’m back to who I was before sepsis. Although I’m still afraid of acquiring other infections, this is no longer a constant fear as it was for a few years after I was hospitalised. I have known many cases like mine, but only a few with a positive outcome. I see that in Brazil and worldwide many people do not know what sepsis is (my mother had never heard of it, at 55 years old). Many people also don’t know the symptoms, when to seek help and the fact that sepsis does not only affect the elderly or people with comorbidities. Many people die of sepsis and family members are only informed about other causes (like pneumonia). I think professionals may find it easier to explain to the family member what pneumonia is than what sepsis is.
There is a need for continuing health education for both health professionals and the community to reverse this paradigm.
Antimicrobial resistance (AMR) impacts sepsis by making the infections that cause sepsis harder to treat, as the usual antibiotics become ineffective. This can lead to increased mortality rates, prolonged hospital stays, and higher healthcare costs due to the need for more complex and expensive treatments. However, not all sepsis infections are resistant, and many can still be effectively treated with standard antibiotics.
My main wish regarding sepsis is that all patients have access to what I had, that is: early and effective diagnosis and treatment. This is a fundamental point for the prognosis of these patients, as it was for me.
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Leticia Batista
Leticia has a Master’s degree in Medical Sciences from Unifesp/EPM, where she conducted research in the Clinical Immunology Department, focusing on rare diseases, inborn errors of immunity, and human immunoglobulin. She also has more than five years of experience in clinical assistance, with a focus on rehabilitation. She actively participates in meetings with medical teams and other health professionals, involving discussions of scientific articles, treatment guidelines, and mapping the patient’s journey.
She survived septic shock and two multidrug-resistant infections caused by Klebsiella pneumoniae carbapenemase (KPC) and Pseudomonas aeruginosa in 2018. Since then, she has volunteered with the Instituto Latino Americano de Sepse. She has also been a speaker at national and international events, focusing primarily on patient engagement, giving them a stronger voice and empowering them to gain more control over their healthcare decisions.
