Public is warned to keep cuts clean after bacteria case surfaces

The state Department of Health is warning the public to keep wounds clean after a Kauai man was confirmed to have a flesh-eating bacteria.

Those cleaning up after the recent storms should take care to avoid cuts or abrasions while working in or around fresh water, moist vegetation and storm debris.

"If you have a cut or wound, take good care of it, keep it clean, keep it protected from getting exposed to potentially dirty sources, dirty areas, especially if you’re involved in flood cleanup or just out gardening or hiking," said Sarah Park, chief of the Disease Outbreak Control Division at the state Department of Health.

John Stem:
He is suffering
from flesh-eating bacteria

"If you see increasing redness, warmth, swelling and/or pain at the site of a wound or cut, you need to let the doctor know sooner than later," she said.

The warning comes after the state confirmed Lihue resident John Stem has necrotizing faciitis, or flesh-eating bacteria, and fielded reports of other possible cases.

Two suspected pediatric cases were reported on Kauai but were identified as a different kind of infection, Park said.

Janice Bond, Stem’s mother, said the infection was still spreading under her son’s left arm and he underwent another surgery at Straub Clinic & Hospital on Friday.

Since Bond found her son unconscious in his apartment March 10, the infection has spread from his legs to his back, abdomen and chest. Doctors have been cutting away infected tissue every day. Stem regained consciousness Tuesday and was flown from Kauai to Oahu Thursday night for specialized treatment and reconstructive surgery.

Park said investigators are trying to determine how Stem got the infection, although his mother said she suspects he may have contracted it last week in the storms during his work as a sales agent for a pesticide company.

Park said the two most common bacteria associated with necrotizing faciitis are group A streptococcus and staphylococcus aureus — both often found on the skin — but the infection can also be caused by multiple bacteria working together. Once the infection becomes necrotizing faciitis, it can spread rapidly.

"When the infection is small, you can get ahead of it quickly," she said. "If it’s going to get complicated into something like a necrotizing faciitis, the definitive therapy is surgical. You need to cut out the tissue that’s affected, that’s dead, because if you leave it in there, the antibiotics can’t do anything. Treatment is a combination of surgery and antibiotics."

It’s "kind of a race" to cut away dead tissue before the infection spreads, she said.

"It’s not a common complication," Park said, "but we do know it can occur and it just really gets back to stressing … go see your doctor sooner than later."