From the Publisher
“Could hardly be more timely.” The New York Times
“Brings the battle against dirt firmly into the 21st century.” The Washington Post
“Explains how our obsession with cleanliness led us to this point and details how science may still find a way past the danger.” O, The Oprah Magazine
Science writer Sachs (Corpse) makes a strong case for a new paradigm for dealing with the microbial life that teems around and within us. Taking both evolutionary and ecological approaches, she explains why antibiotics work so well but are now losing their effectiveness. She notes that between agricultural antibiotic usage and needless prescriptions written for human use, antibiotic resistance has reached terrifying levels. A decade ago, resistant infections acquired in hospitals "were killing an estimated eighty-eight thousand Americans each year... more than car accidents and homicides combined." Our attempts to destroy microorganisms regularly upset useful microbial communities, often leading to serious medical consequences. Sachs also presents evidence suggesting that an epidemiclike rise in autoimmune diseases and allergies may be attributable to our misguided frontal assault on the bacterial world. The solution proposed is to encourage the growth of healthy, displacement-resistant microbial ecological communities and promote research that disrupts microbial processes rather than simply attempting to kill the germs themselves. Despite the frightening death toll, Sachs's summary of promising new avenues of research offers hope. (Oct. 16)Copyright 2007 Reed Business Information
The human body, science writer Sachs (Corpse: Nature, Forensics, and the Struggle To Pinpoint Time of Death) makes clear, hosts a teeming ecosystem of microorganisms, which, like a terrestrial ecosystem, owes its survival to the balanced interrelationships of its inhabitants. The ecosystem of Homo sapienshas evolved over millennia to optimize our species' healthy development. Sachs reports, however, that scientists increasingly suspect that 19th-century advances in sanitation and the 20th-century advent of antibiotics have inadvertently disrupted these ancient symbioses. Increasingly, allergies, autoimmune diseases, and widespread drug-resistant bacteria are the unintended consequences of the modern world's dramatic medical progress. Fortunately, Sachs softens her bad news with stories of promising research, including new vaccines that may prevent diseases requiring antibiotic treatment, "probiotic" cultures that restore internal microflora balance, and, more controversially, genetic manipulation of bacteria to improve the virus-fighting qualities of friendly bacteria or to hinder the reproduction of those causing disease. The paradigm shift of working with instead of against bacteria has the potential to revolutionize 21st-century medicine; Sachs's book is a thoughtful lay reader's guide to this emerging field. Recommended for most libraries.
Chapter and verse on the bugs that outnumber, outwit and no doubt will outlast us. The good news is that for the most part these bugs, aka bacteria, help or at least do no harm. With us since birth, the resident flora help digest and extract nourishment from what we eat, asking little but leftovers in return. Comfortably lodged in our various niches, they also impede hostile takeovers by the not-so-nice species, which is one reason we suffer diarrhea or other complaints. Sachs (Corpse: Nature, Forensics, and the Struggle to Pinpoint Time of Death, 2001) deals with the well-known problems of human antibiotic abuse that leads to scary headlines about hospital superbugs or extensively drug-resistant tuberculosis, but she also covers the overuse of antibiotics for livestock, which ensures that at least some highly drug-resistant bugs make it to the supermarket. She explains the many ways bacteria acquire resistance: via mutations, but also through the exchange of genes within a strain (bacterial sex) and across species; genes are also ferried into bacteria by invading viruses. Sachs points out that most antibiotics are derived from bacteria species that have a supply of resistance genes sequestered in their main chromosome ready to be turned on to prevent bacterial suicide. Humans' built-in defenses are largely the components of the immune system, the antibody-producing and killer cells, as well as the ones that trigger allergic sneezes. The latter branch of the system may be in overdrive, she suggests, as we excessively spritz the latest bactericidal sprays and cleaners. This "hygiene hypothesis" posits that the reason for increases in asthma, allergies and autoimmune diseases in thedeveloped world is that the immune system, for want of normal disease-fighting activity, overreacts to any stray molecule it senses, triggering an inflammatory response. Sachs discusses a variety of proposed solutions for infection as well as allergy, but basically the message is, "Get over it! Learn to live and let live in a natural balance."