When a few spots resembling insect bites appeared on his body, Mr Chia De Qin did not give them a second thought.
The Management Development Institute of Singapore (MDIS) graduate, 21, thought the spots would go away by themselves.
Two of the spots - one on his knee and the other on his left buttock - became so painful and swollen with pus that he had to seek help to drain out the pus regularly.
"I couldn't sit or stand because it simply hurt too much. It was affecting my life," said Mr Chia of his agony earlier this year.
He was diagnosed with a methicillin- resistant Staphylococcus aureus (MRSA) infection.
MRSA is a type of bacteria that is resistant to methicillin and other related antibiotics.
A recent local MRSA study shows there have been three types of the super bug in Singapore over the past three decades, demonstrating the tenacity of the bacteria and its constant evolution.
Speaking to The New Paper yesterday, Mr Chia said he started developing spots that looked like insect bites two days after working out at a gym in May.
"I didn't shower immediately after exercising. It was the only occasion I remember not keeping clean," said the student.
He ignored them as they did not itch, were not painful and looked nondescript.
But the spots started to swell after four days to about 4cm in diameter and became too painful to touch.
Pus started forming in the wounds. Mr Chia said: "I tried to drain out the pus myself but it was still very painful.
It was painful enough for me to think that I couldn't handle it any more.
"I later went to a dermatologist every two days to drain out the pus.
Imagine each wound was like a hole after it was drained.
"After draining my existing wounds a few times, the dermatologist kept discovering new wounds. They just kept appearing," said Mr Chia, who counted nine spots in total on his shoulder, back, inner thigh and calf at the peak of the infection.
He was diagnosed with an MRSA infection after a culture swab revealed the presence of the bacteria, and was referred to infectious diseases specialist Dr Leong Hoe Nam a month later.
The pain - which Mr Chia rates as eight on a scale of 10 - kept him up at night. He also had to endure the soreness and sit through an exam the same month he was diagnosed.
"I was already in so much pain but had to try to write four essays. It hurt so badly that I couldn't concentrate," he said.
There was no way he could postpone the exam unless he chose to repeat the module or be satisfied with a passing grade, he said. He scored an A in the subject in the end.
He added that he turned down invitations to go out as he had difficulty walking and did not want to add to his discomfort.
He was cleared of the infection only in July after being prescribed strong antibiotics that he had to take four times a day. It cost him more than $3,000 for the treatment over two months.
The MRSA infection left Mr Chia with blemishes on his body which will fade over time, but he is scarred by the experience.
"I can't say for sure how I got the infection but I haven't worked out since," he said.
Methicillin-resistant Staphylococcus aureus (MRSA) may occasionally enter the body through breaks in the skin, like abrasions, wounds, surgical incisions or indwelling catheters and cause infections.
Infections may range from mild (pimples or boils) to severe (infection of the bloodstream, bones or joints).
How it spreads
It often spreads through touch. It can also spread through surfaces such as door handles or unclean beds.
MRSA infections can be divided into two groups: healthcare-associated, where infections are through wounds or lines for intravenous drugs; and community-associated, where infections are spread in the community through contact, and the infected have no previous hospital exposure.
The three decade study
A study on 260 bacteria samples from 1982 to 2010 revealed three MRSA variants over the three decades.
While MRSA infections in local hospitals have been falling since 2008, it is still four times higher than the figures in the UK, said Dr Hsu Li Yang, the study's principal investigator.
Figures show that as of March last year, there were 364 MRSA reports in the UK.
Dr Hsu said: "...hospitals or trusts (in the UK) are penalised financially if the rates of MRSA are high; there is mandatory reporting of MRSA infections; and there is also significant funding provided for initiatives to reduce MRSA rates."
High patient load in Singapore also plays a part, Dr Hsu added.
"When there are a lot of patients and overworked staff, infection control measures including hand hygiene inevitably become compromised," he said.
This article was first published on October 20, 2015.
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