The Killers Within: The deadly rise of drug-resistant bacteria by Michael Shnayerson and Mark Plotkin, Little, Brown, $24.95, ISBN 0316713317
A retired New York detective on kidney dialysis became infected with Staphylococcus aureus. Because the bug was resistant to methicillin, his doctor prescribed vancomycin and sent him home. But his illness worsened and he died 12 hours after readmission to hospital. The bacterium did not respond to vancomycin either.
Just one of many stories in The Killers Within that illustrate the human consequences of the burgeoning horror posed by antibiotic-resistant bacteria. Michael Shnayerson and Mark Plotkin are bang up to date in sketching the dimensions of the problem. I was particularly impressed by their discussion of political battles over the misuse of antimicrobials in animal husbandry and of the potential use of bacteriophages as replacements to combat human infections.
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But this vivid portrayal of the adverse consequences of bacterial evolution is seriously impaired by a worrisome accumulation of errors. Howard Florey and his Oxford team did not 鈥渢urn Penicillium into penicillin鈥�; they used the first to make the second. Streptococcus pyogenes is not necrotising fasciitis but its cause. Staphylococci are not 鈥渆ssential to digestion鈥�. Antibiotics do not 鈥渇loat in water鈥�.
Above all, the assertion that 鈥渕ost bacteria are fully capable of finding ways to cause us harm, either in the bloodstream or the skin鈥� is risible. Most bacteria are beneficial, especially those in the soil that recycle nitrogen and other elements 鈥� and what about those that gave us antibiotics? Shnayerson and Plotkin have a strong story to tell, so they could easily have skipped the misleading hyperbole.
The focus is strongly on the US. Deaths in this book, for example, are American deaths. Some sections on developments in several European countries, however, are marred by insufficient knowledge. For example, the 1969 committee under Michael Swann which restricted antibiotic growth promoters in animal husbandry in Britain did not act on 鈥渁necdotal evidence鈥�. It responded to the painstaking researches of E. S. Anderson, then at the Enteric Reference Laboratory at Colindale.
Anderson was a world pioneer in fathoming the genetics of drug resistance without the benefit of modern techniques and in tracing outbreaks of salmonellosis in farming communities. His name does not even appear in the book. That of another British pioneer, H. Williams Smith, is incorrectly cited.
Read The Killers Within for its ebullience and its insights into the work of present-day microbe hunters in the dangerous battleground of antibiotic resistance. But take care over some of the detail.