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After the Edmonton Oilers’ billionaire owner recently made a rare appearance at a press conference to announce the hiring of the team’s new general manager, Daryl Katz became news himself. It turns out that the reclusive pharmacy magnate, whose facial appearance has been visibly altered, is dealing with a life-threatening antibiotic-resistant sinus infection.
His experience is one more reminder of the fact that antibiotic resistance is on the rise and that “superbugs” are a real, potentially deadly threat.
The sinus infection is one that Katz been battling for years, and which has required drastic intervention.
Sportsnet hockey analyst John Shannon tweeted some details, including the fact that Katz needed around-the-clock intravenous antibiotics as far back as 2017, that were later confirmed by the Oilers organization.
"[Katz] carried an IV bag 24/7 during the playoff run, two seasons ago. The infection has a 50-50 survival rate. He’s had three surgeries over the past 10 months with one more surgery to go. It is the primary reason why he hasn’t been around Edmonton and the team," Shannon wrote on Twitter.
Apparently, Katz’s prognosis is good, but what can happen with an infection like his is that it can take over the entire body, says Toronto microbiologist and immunologist Jason Tetro.
Sinus infections can be either viral or bacterial, the host of the Super Awesome Science Show explains. With the latter, they can sometimes cause abscesses within the septum, a membrane that divides the two nostrils. That’s because bacteria need to eat, and when they’re in the nose, they consume cartilage and cells.
Although Tetro can’t comment on Katz’s case specifically, here’s how an infection like his could play out:
Most people who notice symptoms and have a bacterial sinus infection will take antibiotics and recover. But say you have an infection that isn’t going away or is getting worse even with antibiotics, however. Three or four weeks later, your doctor prescribes a different type of antibiotic, which doesn’t work, either.
Then you go down a path of trying to find the right combination of antibiotics, and there’s a risk of sepsis. The condition results from the presence of harmful microorganisms in the bloodstream or other tissues, potentially leading to organ malfunction, shock, and death. At that point, surgery may be needed in an attempt to remove the abscess, in hopes of preventing the bacteria from travelling to other parts of the body. If lymph nodes or sections of bone on the face need to be removed, cosmetic surgery might be required, too.
“Then as you’re going through this, if it looks like you haven’t gotten everything, and there’s a potential for it to enter bloodstream, then you’re going to have fight the bugs in the blood with an IV drip with antibiotics 24/7,” Tetro says. “When you’ve reached that point, then it really becomes a race against time.”
Antibiotic-resistance has varying degrees. Multidrug resistant organisms (MDROs) resist two or more antibiotics. “When that happens, the struggle is getting longer, the bacteria are going to always be there to continue to eat away at whatever it’s eating at, because that’s food,” Tetro says.
Finding the right combination of antibiotics could take months and months. Tetro notes that this has been seen with tuberculosis, pneumonia, urinary tract infections, and other illnesses. During this time, bacteria could enter the bloodstream and start eating away at different parts of your body. There have been cases of people with strep throat infections who have gone on to lose fingers and toes.
“As you go on longer, there’s a greater likelihood that you’re going to have that spread of bacteria into your body,” Tetro says. “Surgery to remove the abscesses can possibly help but if it starts forming colonies in other areas of your body, you’re having to go through multiple surgeries to get rid of it.”
The worst-case scenario is pan-resistance: when bacteria are resistant to all antibiotics. Such cases are rare but not unheard of. In 2017, for instance, a woman in Nevada who had an infection in her hip ended up dying because not a single type of antibiotics available in the United States could conquer the bacteria. “The prognosis in this particular case is very, very, very, very, very poor,” Tetro says.
So, what can people do to keep this an aggressive sinus infection at bay? There are a few ways.
The best is prevention, Tetro says. Proper hand-washing is vital to avoid acquiring an infection in the first place.
“Try and keep the integrity of your sinuses as best as possible,” Tetro adds.
If you must pick your nose, don’t do it after you’ve been handling raw meat, Tetro notes: “That’s just asking for trouble.”
If you feel that your sinuses are inflamed and you’re not feeling better after about four to five days, see your health-care professional. A swab can identify what type of infection it is. “It may still be viral, but it’s better to be proactive,” Tetro says.
We can’t stop the spread of antibiotic-resistance, but we can avoid antibiotics when they’re not necessary and use them properly when they are.
“If you end up needed one, you take it and you take it to the very end,” he says. “If it looks like it may not be necessary, don’t ask for one. Let the doctor initiate that discussion.”
Medical experts are looking at alternatives to antibiotics. Phage therapy is one: the use of bacterial viruses (phages) to treat bacterial infections.