Wednesday, 6 September 2017

Review: Superbug: The Fatal Menace of MRSA by Maryn McKenna

Superbug in three words: Scary. Thorough. Illuminating. 

Antibiotic resistance has been my thing, my #1 project, for almost two years now, and I've talked to hundreds of students about the importance of saving antibiotics, but I never had much of an insight into the human cost of antibiotic resistance until I read this book. The book is essentially a collection of MRSA victims' stories, and in some parts is very very sad, talking about a twelve-year-old who went on a camping trip, got sick and ended up dying in hospital after several days frantically trying to save his life, MRSA having caused systemic organ failure after destroying his lungs. I read "23,000 people in the US die every year from MRSA" ages ago but Superbug brought home the emotional pain of each one of those deaths. 

Apart from the deaths, there were lots of stories of MRSA destroying lives and losing people their jobs or homes because recurring infections forced so many hospital stays or moving house.

My favourite parts were the most sciencey parts, like the discussion of PVL, a toxin discovered by French scientists that's responsible for destroying lung tissue in MRSA pneumonia, and the many, many references at the end which have given me a lovely reading list of journal articles. I also enjoyed all the detective hunts, where McKenna documented how scientists tracked down the causes of MRSA epidemics, and the creative solutions scientists came up with. For example, MRSA was spreading in a hospital nursery for newborns and scientists dislodged the meticillin-resistant staph aureus with a different, non-virulent, kind of staph. There were some problems with it later on but it worked to stop the MRSA outbreak there.   

McKenna also tracked the spread of MRSA through agriculture in one chapter, showing how it could pass from livestock fed antibiotics to humans and back again, causing outbreaks. 

An interesting chapter was about the process of developing antibiotics and why so many pharmaceutical companies now don't consider it worthwhile because resistance appears so fast. 

A big theme of the book was the convergence of two epidemics, traditional hospital-acquired MRSA (hospitals are a perfect breeding place for resistant organisms because there are so many antibiotics around that it creates a strong selection pressure on bacteria to become resistant) and community-associated MRSA, where people caught the infection outside the hospital. In the convergence, community-associated strains of MRSA started appearing in the hospital and vice versa, so the terms are losing their usefulness. The fear is that community strains of MRSA could pick up the multidrug resistance of hospital MRSA (most community MRSA is resistant to beta-lactam antibiotics and some others, whereas the hospital ones are resistant to a much wider range of antibiotics), and the hospital strains could pick up community MRSA's virulence, its ability to cause devastating diseases. 

The book was very thorough; McKenna is a good writer and did hundreds of interviews with victims, their medical teams and other sources to corroborate stories, read a thousand journal articles and more, so she managed to say a lot about one species of bacteria. She did a good job of making the science accessible, in my opinion, though at points I would have preferred a higher science:story ratio (this is one of the reasons Leon tells me I should just read textbooks). The stories could get a bit repetitive sometimes, but I did like that she seemed to have all angles covered and showed the many ways MRSA could attack. 

It's not a hopeful book, so don't read it if you want to be cheered up. I'm not sure how she didn't get depressed writing it, honestly. But if you're interested in antibiotic resistance, have a look at it. 

No comments:

Post a Comment