BIOGRAPHY OF RESISTANCE

A vivid portrayal of our fight against an opponent that has been around for more than 3 billion years.

Zaman, a professor of biomedical engineering and international health, portrays a conflict—between humans and harmful strains of bacteria—that has played out in plagues and epidemics over millennia. That drama has now taken a turn for the worse with the rise of antibiotic resistance. In the U.S. alone, writes the author, more than 35,000 people die every year from drug-resistant infections. One of the primary causes is the overprescription of antibiotics and widespread use in industrial agriculture and livestock for prophylaxis and growth promotion. Bacteria mutate rapidly, and those that survive an antibiotic can pass their resistant genes to progeny as well as to other bacteria species. Indeed, one of Zaman’s main points is that bacterial resistance is not new. Bacteria have been engaged in a Darwinian evolutionary competition among themselves since their origin. Samples of bacteria from a newly unearthed deep cave in the U.S.—and from the guts of an isolated tribe in Venezuela—contained bacteria that were resistant to a slew of contemporary antibiotics. The practice of modern medicine has upset a balanced equilibrium. Outside the U.S., antibiotic resistance is occurring where the drugs are available without a prescription and frequently used. They may also be adulterated or substandard and so further encourage antibiotic resistance to infections that are themselves the result of poor hygiene and sanitation. Using firsthand observations from around the world, the author presents many examples of disease outbreaks and the experts and efforts used to resolve them. These vignettes follow chapters that capture the history of bacteriology and the scientists working to fight bacterial resistance, highlighting the usual suspects—and not sparing the moral shortcomings of some. So what next? Despite continued antibiotic resistance and few drugs in the pipeline, Zaman is optimistic, citing new interest in phage therapy and experimental research funded by private foundations and other ventures.

A compelling call to action demanding that governments and scientists rise to the challenge.