Mutant Bacteria and the Failure of Antibiotics
- From: rpautrey2 <rpautrey2@xxxxxxxxx>
- Date: Thu, 25 Jun 2009 12:07:08 -0700 (PDT)
Mutant Bacteria and the Failure of Antibiotics
The Killers Within: The Deadly Rise of Drug-Resistant Bacteria
by Michael Shnayerson and Mark J. Plotkin
Reviewed by
Merete Rietveld
Posted: April 4, 2003
Hospitals have germs. And germs have a remarkable ability to develop
resistance to the antibiotics we rely on to kill them. These facts are
well known to the medical community and have been a source of great
concern for years. A number of books and articles for both the lay
reader and the professional have been written on the subject, each in
its way raising a red flag that says, in one way on another, we have
to control the use of antibiotics less we lose them to smart bacteria
that learn to become immune to their toxic effects.
Michael Shnayerson and Mark J. Plotkin, authors of The Killers Within:
The Deadly Rise of Drug-Resistant Bacteria, have now joined the army
of alert writers who are concerned about the dangers of antibiotic
resistance and its implications for the return of infectious diseases
that cannot be effectively treated. The authors argue that today’s
hospitals are not only spreading bacteria from patient to patient, but
are also harboring a tougher breed of bug—one that is resistant to
antibiotics.
Most infections are either bacterial or viral, and bacterial
infections are susceptible to antibiotics. These drugs are designed to
attach to enzymes on bacterial cell walls, either preventing the
microbes from replicating or killing them outright. Unless, that is,
the bacteria mutate and change their enzymes, thus preventing the drug
from attaching.
Penicillin was greeted as a panacea when it was developed in the
early-20th century. In the decades since, the authors claim—as have
others before them—that the overuse of antibiotics for every possible
illness has “educated” bacteria, creating opportunities for mutations
to occur: “If misuse of antibiotics created drug resistance in the
first place, poor infection control in hospitals allowed the bugs to
spread.”
Bacteria may be small, but these one-celled organisms can divide and
reproduce into more daughter cells than the human population of Earth
in just fourteen hours.
Plotkin, an ethnobiologist, and Shnayerson, a contributing editor to
Vanity Fair, report what they have learned from interviews and the
scientific literature about how bacteria develop resistance and the
role genes play in this process. They express admiration for
bacteria’s clever defense mechanisms, including the evolution of
enzymes that attack antibiotics and tiny pumps that vomit the drug out
of the cell.
--------------------------------------------------------------------------------
People are dying of bacterial infections that were treatable a few
years ago.
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In the first half of this book, the authors try to scare the general
public into recognizing the seriousness of the threat (chapter titles
include “The Silent War,” “Nightmare Come True,” “Flesheaters”).. Yet
despite the scare tactics, the authors succeed in creating a
suspenseful narrative.
Indeed, their claim that the medical industry has not taken growing
drug-resistance seriously enough and has failed to improve antibiotics
suggests a fatal conclusion fitting of Stephen King: People are dying
of bacterial infections that were treatable a few years ago.
By shadowing scientists around the globe—including the “genetic
detectives” and “microbe hunters” who work with the world’s most
dangerous pathogens, as well as epidemiologists investigating
outbreaks of bacterial infection—the authors craft an informative
thriller with vivid descriptions and tales of scientific sleuthing.
The book tells the story, for instance, of William Noble, a
microbiologist at St. John's Hospital for Diseases of the Skin in
London, who, in the early 1990s, created a strain of Staphylococcus
aureus that was resistant to the antibiotic vancomycin by exposing the
microbe to another bacterium with resistant genes. A few years later,
a vancomycin-resistant S. aureus was isolated from a lung-cancer
patient in Japan, suggesting that Noble's laboratory experiment had
happened in nature.
Like hospitals, the meat industry is a source of rising drug-
resistance. Small doses of antibiotics (called “growth-promoters”)
added to animal feed contribute to the development of resistant
strains by familiarizing bacteria with the drugs without actually
threatening them. The authors argue that substantial research shows
that these resistant bacteria are easily transferred to humans eating
these animals.
Toward the end of the book, the authors leave behind the horrors of
resistant bacteria and begin to describe the search for new
antibiotics. Until recently, most natural antibiotics have been found
in soil and fungi. Among the scientists trying novel approaches to
discovering antibiotics are researchers who collect saliva from
lizards in Indonesia and distill sewage water in the former Soviet
Republic of Georgia.
These researchers are experimenting with animal peptides and miniscule
viruses that act as natural antibiotics. Peptides punch their way
through the bacterial cell membrane regardless of these enzymes.
Scientists in Georgia have been using viruses called “phages” for
decades to puncture the bacterial membrane but with the purpose of
injecting DNA. Phages take over the bacteria’s genetic machinery in
order to produce more phages, rather than bacteria. An interesting
footnote in this passage is that phages are also the basis of genetic
engineering: Geneticists insert certain genes into phages, prompting
the bacteria to manufacture those genes.
The subject of resistant bacteria is not breaking news. The problem
has been widely discussed in the medical community although the
general public may not be as familiar with the issue. While the
authors focus on the ignorance and blindness of the medical community
towards this problem, they also reveal the obstacles preventing new
antibiotics from being developed and problematic behaviors from being
changed.
For readers interested in the topic, The Killers Within provides an
overview of the biological, medical, policy-oriented and personal
perspectives involved. And for those who have the stomach to digest
the chilling dangers posed by resistant bacteria, this book will be a
thrilling read.
Merete Rietveld is a freelance writer who lives in Palo Alto,
California.
Shnayerson, Michael and Plotkin, Mark J. The Killers Within: The
Deadly Rise of Drug-Resistant Bacteria Little, Brown and Company,
Boston (2002).
.
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