Thursday, December 27, 2007

"Good Germs, Bad Germs"

Jessica Snyder Sachs is a contributing editor to Popular Science and Parenting magazines and writes regularly for Discover, National Wildlife, and other national publications. Prior to becoming a full-time freelance writer in 1991, she managed and edited Science Digest.

She applied the Page 69 Test to her latest book, Good Germs, Bad Germs: Health and Survival in a Bacterial World, and reported the following:
Page 69 of Good Germs, Bad Germs lands us smack in the middle of the new war against “stealth infections.” It's about how a new generation of microbe hunters has begun using DNA fingerprinting to comb through the body for bacteria we never knew were there. Are these bugs causing disease or are they innocent bystanders?

Hopefully, the information is compelling enough to get the page-69 reader to read on. For to stop here could leave the WRONG impression. That's because the idea of eradicating these so-called stealth infections may cause far more harm than good. The danger lies in the possibility that their discovery will set off a call to arms that brings about a historic increase in antibiotic use before we have applied the hard-won lessons of our first Hundred Year War on germs. So here's page 69…

In the early 1990s, while analyzing the joint tissue of arthritis sufferers, Hudson turned up two types of chlamydia -- Chlamydia trachomatis, normally associated with genital and eye infections, and Chlamydia pneumoniae, a common cause of respiratory infections. More famously, in 1996 he began fishing C. pneumoniae out of the brain cells of Alzheimer's victims.

Around the same time, medical researchers began finding the genetic fingerprints of C. pneumoniae and various kinds of mouth bacteria in the arterial plaque of heart attack patients. This finding spurred many cardiologists to begin putting their patients on antibiotics, a practice largely stopped in 2005. That year brought the much-anticipated results of a study involving more than four thousand heart disease patients who had been taking the powerful antibiotic gatifloxacin for two years.

The results of the study confirmed that the treatment failed to reduce the risk of heart attack or the degree of atherosclerosis, or artery blockage. However, the trial did not so much exculpate C. pneumoniae as demonstrate that even long-term courses of strong antibiotics fail to fully eradicate it.

So the study, while it squelched the growing use of gatifloxacin among cardiologists, opened up tremendous interest in developing stronger, more effective drug regimens to eradicate not only C. pneumoniae but also a growing number of other so-called stealth infections.

Clearly, the financial incentives are huge. If, for example, a powerful new antibiotic proved even partially effective in reducing the risk of heart attack, the resulting prescriptions would number in the millions, possibly tens of millions. “We're talking about the majority of the population being on long-term antibiotics, possibly multiple antibiotics,” says Vanderbilt University chlamydia specialist William Mitchell, cofounder of a company pursuing just such a cure. Moreover, if preliminary results are any indication, these would be prescriptions not for a several-day course of antibiotic, but for months, possibly years, of daily use.

More recently, psychiatrists have begun putting young patients with obsessive-compulsive disorder on long-term antibiotics, a trend that …
Read an excerpt from Good Germs, Bad Germs and learn more about the book and author at Jessica Snyder Sachs' website.

Visit the complete list of books in the Page 69 Test Series.

--Marshal Zeringue