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The Killers Within: The Deadly Rise Of Drug-Resistant Bacteria
Go behind the scenes and learn the shocking truth about how physicians are fighting against new and evolving bacteria in this "compelling -- if terrifying -- account of the rise of antibiotic resistance" ( Wall Street Journal ).
Right now, a battle is taking place on the frontiers of medicine between rapidly evolving bacteria that threaten our health and the doctors who are struggling to outwit them. These bacteria are in and on our bodies, in homes, schools, hospitals, crowded airplanes, day-care centers. And, as The Killers Within makes frighteningly clear, so far the bacteria are winning.
Right now, a battle is taking place on the frontiers of medicine between rapidly evolving bacteria that threaten our health and the doctors who are struggling to outwit them. These bacteria are in and on our bodies, in homes, schools, hospitals, crowded airplanes, day-care centers. And, as The Killers Within makes frighteningly clear, so far the bacteria are winning.
336 pages, Paperback
First published January 1, 2002
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Displaying 1 - 15 of 15 reviews
September 9, 2016
4 1/2 Stars. I grew up during a time when antibiotics where used and used again and used yet again. I have read this book because I have antibiotic resistance, including MRSA that lives inside my ankle as a result of an old break. This book was nearly always accessible to me because of my own medical history of resistance and because of my awareness of livestock being fed antibiotics as growth promoters and illness prevention efforts. I learned of ways to protect the healthy members of society and to combat infections without using antibiotics. I hope and pray that the US Food and Drug Administration (FDA) approves of some of these new ways--And that equivalent organizations around the world approve of these new ways. I hope and pray that these new methods of dealing with bacterial infections are accessible to all.
Worth re-reading sections of this book.
Worth re-reading sections of this book.
February 5, 2014
The Killers Within describes the human fight against infectious bacteria. The book includes the use, abuse and effects of antibiotics in humans and animals, along with a very nice summary of how bacteria gain resistance to antibiotics. The book also discusses phage therapy and various other means that scientists have considered for treating bacterial infections. This is a well written story of the fight against bacteria, including doctor's personal anecdotes and science bits that are not too technical but still full enough to be useful. This book is extremely interesting and informative.
November 17, 2008
This is a science book, so it might not be for the nonscience field person. But if you want to become familar with antibiotic resistance and how we (you, me, and everyone) are overusing antibiotics and the harm we are bringing upon ourselves its a good read. Its not written like a journal article it's kind of a compilation of short stories.
August 1, 2011
A terrifying read - once again our short term policies and practices have put us in greater danger in the long-term. Points to take away: stay healthy, stay away from hospitals, don't take antibiotics unless necessary, and try to avoid eating meat which has been fed antibiotics as growth promoters.
August 29, 2019
The frightening return of infectious disease
This book is scary. According to ethnobotanist Mark J. Plotkin and longtime Vanity Fair contributing editor Michael Shnayerson, the golden age of antibiotics that began with penicillin, a time when it was generally thought that infectious diseases were under control and largely a menace of the past, is over. Our naivete and our arrogance in imagining that we had just about defeated the bugs and could move on to other more pressing public health concerns came to an end in the nineties as one after another of the major human borne bacteria became resistant to our drugs. Through the exchange of DNA, that immunity has been transferred to other bacteria so that, as this book went to press just a few months ago, infectious diseases caused by bacteria are once again a major threat to humans everywhere in the world.
What happened? As the authors explain there are three main problems, (1) the overuse of antibiotics by the medical profession, (2) the misuse of antibiotics as growth enhancers in the meat and poultry industry, and (3) the failure of hospital personnel to follow CDC guidelines on hygiene, especially simply washing their hands.
(1) Too many doctors, either through ignorance or a desire to please their demanding patients, have over-prescribed antibiotics for routine infections, and in some cases actually prescribed antibiotics for viral infections (for which they are useless) "just in case" the patient also gets a bacterial infection. The result of this massive overuse of antibiotics is to give the bugs countless trillions of generational opportunities to evolve defenses against the antibiotic, leading to the antibiotic becoming useless.
(2) Tons of antibiotics--"24.6 million pounds a year," see p. 123--are routinely added to animal feed by the meat and poultry industry to promote growth so that their products will get fatter faster. What has happened is that the bugs have grown resistant to the antibiotics while transferring that immunity to bacteria living in, on and around humans. Even the use of an "analogue" antibiotic such as growth promoter virginiamycin can promote changes in bacteria that make them resistant to the antibiotic Synercid (e.g., see pages 115, 119 and 285). As the authors chronicle, this is a serious problem fraught with angry political battles as the meat and poultry people fight to maintain their profit margins while the disease control people fight to restrict the use of growth promoters.
(3) Surprisingly enough the authors report (see page 282 and elsewhere) that there is cynicism among some hospital personnel about the effectiveness of washing their hands and a belief that hygiene won't stop the proliferation of the bugs. The result is that hospitals have become very dangerous places. Most of the drug-resistant bacteria developed their resistance in hospitals. Most (or all) of them are endemic to the hospital environment. If you have to go to a hospital for any reason you are taking a chance of contacting a drug-resistant bug. Heaven help you if you have a compromised immune system, or if you are an infant or an elderly person.
How bad is the situation? According to the authors on pages 278-279 the high cost of developing new drugs (average "$802 million") and the fact that "return on investment from producing an antibiotic that might be used by a patient for less than a week versus return from a drug for a chronic condition that a patient might take daily for fifty years" is persuading big pharma to downsize the antibiotic end of the business. (See also page 94.) The authors ask the question, where are new drugs coming from? and answer that the "great glittering prospect was genomics." But "reality" has "sunk in." (p. 280) Drugs to fight bacteria developed from DNA manipulation "might take even longer to reach the market" than those previously developed. (p. 281)
The authors also touch on the possible use of drug-resistant bacteria as a bioterrorist weapon.
What does all this mean for you and me? It means that should we or our loved ones get a life-threatening bacterial infection, it's possible there won't be an antibiotic around that works. In effect, we might find ourselves back in the days before penicillin (the first really effective antibiotic, and one of the greatest of all medical miracles) when millions of people routinely died from staph, strep, TB and other bacterial infections. As Shnayerson and Plotkin report, right now there are strains of bacteria, including Staphylococcus aureus (the golden-globed bacteria pictured on the cover), Streptococcus pneumoniae, and the Mycobacterium that causes tuberculosis, that are immune to almost every antibiotic in use. There is even a strain of Enterococcus that is resistant to every antibiotic in use.
The authors do offer some hope. They report on the promising use of bacteriophages (viruses that invade and destroy bacteria)--see the very interesting Chapter 14, "Bacteria Busters." They present the idea of a more vigorously controlled use of antibiotics. If we prohibit their use as growth promoters and use them sparingly in an ordered sequence, perhaps bacteria would not have time to gain immunity and/or would lose it after the antibiotic is no longer in use. As pointed out on e.g., page 183, resistant bacteria are "encumbered" by an "extra chunk of DNA" that gives their non-resistant brethren an "ecological advantage" in an environment that doesn't contain the antibiotic. Additionally, the authors report the theory of population biologist Richard Levins who believes that if antibiotics are "saved for the most severe cases...then natural selection would favor the pathogens that produced the milder symptoms." (Explained on page 287).
Bottom line: this is a fascinating, scary and state of the art report on the pathogen wars written in a readable manner sure to interest not only the general public at which it is aimed but professionals as well.
--Dennis Littrell, author of “The World Is Not as We Think It Is”
This book is scary. According to ethnobotanist Mark J. Plotkin and longtime Vanity Fair contributing editor Michael Shnayerson, the golden age of antibiotics that began with penicillin, a time when it was generally thought that infectious diseases were under control and largely a menace of the past, is over. Our naivete and our arrogance in imagining that we had just about defeated the bugs and could move on to other more pressing public health concerns came to an end in the nineties as one after another of the major human borne bacteria became resistant to our drugs. Through the exchange of DNA, that immunity has been transferred to other bacteria so that, as this book went to press just a few months ago, infectious diseases caused by bacteria are once again a major threat to humans everywhere in the world.
What happened? As the authors explain there are three main problems, (1) the overuse of antibiotics by the medical profession, (2) the misuse of antibiotics as growth enhancers in the meat and poultry industry, and (3) the failure of hospital personnel to follow CDC guidelines on hygiene, especially simply washing their hands.
(1) Too many doctors, either through ignorance or a desire to please their demanding patients, have over-prescribed antibiotics for routine infections, and in some cases actually prescribed antibiotics for viral infections (for which they are useless) "just in case" the patient also gets a bacterial infection. The result of this massive overuse of antibiotics is to give the bugs countless trillions of generational opportunities to evolve defenses against the antibiotic, leading to the antibiotic becoming useless.
(2) Tons of antibiotics--"24.6 million pounds a year," see p. 123--are routinely added to animal feed by the meat and poultry industry to promote growth so that their products will get fatter faster. What has happened is that the bugs have grown resistant to the antibiotics while transferring that immunity to bacteria living in, on and around humans. Even the use of an "analogue" antibiotic such as growth promoter virginiamycin can promote changes in bacteria that make them resistant to the antibiotic Synercid (e.g., see pages 115, 119 and 285). As the authors chronicle, this is a serious problem fraught with angry political battles as the meat and poultry people fight to maintain their profit margins while the disease control people fight to restrict the use of growth promoters.
(3) Surprisingly enough the authors report (see page 282 and elsewhere) that there is cynicism among some hospital personnel about the effectiveness of washing their hands and a belief that hygiene won't stop the proliferation of the bugs. The result is that hospitals have become very dangerous places. Most of the drug-resistant bacteria developed their resistance in hospitals. Most (or all) of them are endemic to the hospital environment. If you have to go to a hospital for any reason you are taking a chance of contacting a drug-resistant bug. Heaven help you if you have a compromised immune system, or if you are an infant or an elderly person.
How bad is the situation? According to the authors on pages 278-279 the high cost of developing new drugs (average "$802 million") and the fact that "return on investment from producing an antibiotic that might be used by a patient for less than a week versus return from a drug for a chronic condition that a patient might take daily for fifty years" is persuading big pharma to downsize the antibiotic end of the business. (See also page 94.) The authors ask the question, where are new drugs coming from? and answer that the "great glittering prospect was genomics." But "reality" has "sunk in." (p. 280) Drugs to fight bacteria developed from DNA manipulation "might take even longer to reach the market" than those previously developed. (p. 281)
The authors also touch on the possible use of drug-resistant bacteria as a bioterrorist weapon.
What does all this mean for you and me? It means that should we or our loved ones get a life-threatening bacterial infection, it's possible there won't be an antibiotic around that works. In effect, we might find ourselves back in the days before penicillin (the first really effective antibiotic, and one of the greatest of all medical miracles) when millions of people routinely died from staph, strep, TB and other bacterial infections. As Shnayerson and Plotkin report, right now there are strains of bacteria, including Staphylococcus aureus (the golden-globed bacteria pictured on the cover), Streptococcus pneumoniae, and the Mycobacterium that causes tuberculosis, that are immune to almost every antibiotic in use. There is even a strain of Enterococcus that is resistant to every antibiotic in use.
The authors do offer some hope. They report on the promising use of bacteriophages (viruses that invade and destroy bacteria)--see the very interesting Chapter 14, "Bacteria Busters." They present the idea of a more vigorously controlled use of antibiotics. If we prohibit their use as growth promoters and use them sparingly in an ordered sequence, perhaps bacteria would not have time to gain immunity and/or would lose it after the antibiotic is no longer in use. As pointed out on e.g., page 183, resistant bacteria are "encumbered" by an "extra chunk of DNA" that gives their non-resistant brethren an "ecological advantage" in an environment that doesn't contain the antibiotic. Additionally, the authors report the theory of population biologist Richard Levins who believes that if antibiotics are "saved for the most severe cases...then natural selection would favor the pathogens that produced the milder symptoms." (Explained on page 287).
Bottom line: this is a fascinating, scary and state of the art report on the pathogen wars written in a readable manner sure to interest not only the general public at which it is aimed but professionals as well.
--Dennis Littrell, author of “The World Is Not as We Think It Is”
January 22, 2009
This is a fascinating - and horrifying - look at drug-resistent bacteria. I work in a hospital and it scares the bejeepers out of me.
Read
December 25, 2020 It's probably not the easiest, quickest read, but the subject was fascinating, and the author tries to give us a little humanizing background on each of the biologists, doctors and researchers mentioined in the stories.
One of the most common ways that bacteria become resistant to antibiotics occurs when patients are given antibiotics for some sort of infection, and then, when they get to feeling better, they stop taking the antibiotic before it has had sufficient time to kill all of the bacteria in their system. Those bacteria which are left are the ones with some sort of natural resistance to that particular medicine, and will pass on their resistance to all of their descendents. Those bugs can then be passed on to other people over time, and the next time that antibiotic is used to combat them, it will not be as effective.
Bacteria, according to conventional wisdom, can easily be killed by various topical agents, like bleach, or by boiling infected clothing in water. Unfortunately for convention, some bacteria form hard little capsules called spores that can go dormant for long periods of time. These spores can survive for twenty years or more, and even up to two hours in boiling water. When conditions are right, they can reactivate and infect new hosts.
Drug companies spend enormous amounts of money promoting their new formulations. "With most kinds of new drugs, a huge marketing campaign might do no medical harm. With antibiotics, it was, perversely, the worst possible way to go. The more a new antibiotic was used, the more quickly bacteria managed, by mutation or importing a gene, to develop a resistance mechanism to it." I hadn't realized that different types of bacteria were able to swap genes back and forth, so that they all have a stock of potentially useful weapons to use in their war for survival.
Another contributing factor to the increase in bacteriological resistances has been the widespread use of antibiotics as growth enhancers in poultry, swine and cattle. Small amounts of antibiotics in their feed have increased the animals' growth, but people who work with the animals, from those who raise them, to those who slaughter them, are then exposed to those antibiotics and the bacteria in the animals, and resistances have been shown to cross species barriers to humans, with often tragic results.
The author paints a chilling picture of the future, when antibiotic resistant bacteria continue to increase their numbers and types. It's been happening since the introduction of antibiotics in the 20th century, and researchers are frantically trying to stay ahead in the arms race. Read at your own risk - of peace of mind.
One of the most common ways that bacteria become resistant to antibiotics occurs when patients are given antibiotics for some sort of infection, and then, when they get to feeling better, they stop taking the antibiotic before it has had sufficient time to kill all of the bacteria in their system. Those bacteria which are left are the ones with some sort of natural resistance to that particular medicine, and will pass on their resistance to all of their descendents. Those bugs can then be passed on to other people over time, and the next time that antibiotic is used to combat them, it will not be as effective.
Bacteria, according to conventional wisdom, can easily be killed by various topical agents, like bleach, or by boiling infected clothing in water. Unfortunately for convention, some bacteria form hard little capsules called spores that can go dormant for long periods of time. These spores can survive for twenty years or more, and even up to two hours in boiling water. When conditions are right, they can reactivate and infect new hosts.
Drug companies spend enormous amounts of money promoting their new formulations. "With most kinds of new drugs, a huge marketing campaign might do no medical harm. With antibiotics, it was, perversely, the worst possible way to go. The more a new antibiotic was used, the more quickly bacteria managed, by mutation or importing a gene, to develop a resistance mechanism to it." I hadn't realized that different types of bacteria were able to swap genes back and forth, so that they all have a stock of potentially useful weapons to use in their war for survival.
Another contributing factor to the increase in bacteriological resistances has been the widespread use of antibiotics as growth enhancers in poultry, swine and cattle. Small amounts of antibiotics in their feed have increased the animals' growth, but people who work with the animals, from those who raise them, to those who slaughter them, are then exposed to those antibiotics and the bacteria in the animals, and resistances have been shown to cross species barriers to humans, with often tragic results.
The author paints a chilling picture of the future, when antibiotic resistant bacteria continue to increase their numbers and types. It's been happening since the introduction of antibiotics in the 20th century, and researchers are frantically trying to stay ahead in the arms race. Read at your own risk - of peace of mind.
February 9, 2019
I picked up this book to get an overview of antimicrobial resistance as part of something I am researching on. I was pleasantly surprised by how engaging the text was. The book reads like a suspense novel at times with the bacteria serving as the ruthless and enigmatic 'killers'. The book does not have in-line citations but does give clues on sources. The science is very well-explained and I ended up with clarity on much that I was uncertain of previously. I am confident there are areas that I would permanently remember simply because of the lucid explanation of the biology. Yet, the book's highlight is how it connects to the human side, how it etches pictures of the various characters connected to the story of antimicrobial resistance. While I as a researcher could care less about the human details of some characters, I can completely understand how important it is for many in order to stay interested in a book about silent, deadly and invisible microbes.
For anyone interested in science and comfortable with coming across scientific names and biological terms terms which, no fear, are conveniently explained in the text, I will highly recommend this book. Since we all get sick sometime, this is an extremely important topic to know for a person living today.
For anyone interested in science and comfortable with coming across scientific names and biological terms terms which, no fear, are conveniently explained in the text, I will highly recommend this book. Since we all get sick sometime, this is an extremely important topic to know for a person living today.
April 22, 2022
At times a bit hard to follow because it gets so technical, but an intensely interesting subject.
February 14, 2017
The Killers Within is a nonfiction book about drug-resistant bacteria. As you read the novel, many different references are made to many significant doctors. Some of which include the CDC, the FDA, and the national government's measures to prevent these strains of bacteria from reproducing. Many of these drug resisting bacteria are found in any persons everyday life, and encountered quite frequently actually. The hypothesis is that these bacteria have been so scorched in antibiotics that they now have evolved to resist these substances. It's like birds evolving to fly, if they couldn't fly, they's be eaten by predators and die. So eventually the birds that could fly became dominant over the ones that couldn't. The main problem is that it is hard for doctors to keep switching antibiotics over the course of a few months because the bacteria have become resistant to that form of antibiotic.
I personally believe this is a major problem in today's world and that it is solvable if the right people have the money to do such. I liked that the author picked such an interesting topic to write and inform the general public about, and that it was easily associated with Layman's terms. One thing that I did not like was the fact that there was little information about how I could help with this problem. I wish it would've had more suggestions for me as a reader to be able to help the issue.
I would recommend this book to nonfiction readers who enjoy or would like to know more about drug-resistant bacteria. It had so much information to be able to follow.
I personally believe this is a major problem in today's world and that it is solvable if the right people have the money to do such. I liked that the author picked such an interesting topic to write and inform the general public about, and that it was easily associated with Layman's terms. One thing that I did not like was the fact that there was little information about how I could help with this problem. I wish it would've had more suggestions for me as a reader to be able to help the issue.
I would recommend this book to nonfiction readers who enjoy or would like to know more about drug-resistant bacteria. It had so much information to be able to follow.
Read
December 14, 2012I thought it was an amazing book. It always kept me Interested on what was going to happen next. It is a book about a growing out rage of bacteria that is rapidly killing every one and doctors are trying to control it before it goes to far and wipes out man kind I would recommend this book to a friend it is very interesting and shows information about how much bacteria we face every day
December 28, 2007
A terrifying account of the rise in drug resistant diseases. I really enjoyed this book, though some of it is hard to get through due to a lot of very in depth information about who did what study and when. We are all gonna die!
December 9, 2013
I think that this was a good book to read as it goes into personal lives of people that had thes diseases. This book was an enjoyable book to read. This book in my opinion does not make a good humanitarian topic. There were some disturbing facts in this book.
February 6, 2016
This gives a good picture of how antibiotic-resuistant bacteria evolve and who has been spearheading the investigations into that, but the authors linger overlong on the details of viral genetics. This is meant more for a professional than for those working outside the medical field.
July 4, 2009
Our CLC Reads. Plotkin is coming in March for a day of workshops! WOOT
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