Good Germs, Bad Germs: Health and Survival in a Bacterial World

by Jessica Snyder Sachs

Making Peace with Microbes

Public sanitation and antibiotic drugs have brought about historic increases in the human life span; they have also unintentionally produced new health crises by disrupting the intimate, age-old balance between humans and the microorganisms that inhabit our bodies and our environment. As a result, antibiotic resistance now ranks among the gravest medical problems of modern times. Good Germs, Bad Germs addresses not only this issue but also what has become known as the "hygiene hypothesis"-- an argument that links the over-sanitation of modern life to now-epidemic increases in immune and other disorders. In telling the story of what went terribly wrong in our war on germs, Jessica Snyder Sachs explores our emerging understanding of the symbiotic relationship between the human body and its resident microbes--which outnumber its human cells by a factor of nine to one! The book also offers a hopeful look into a future in which antibiotics will be designed and used more wisely, and beyond that, to a day when we may replace antibacterial drugs and cleansers with bacterial ones--each custom-designed for maximum health benefits.

Genres: Science, Nonfiction, Health, Medicine, Biology, Medical, Popular Science

304 pages, Hardcover

First published January 1, 2007

About the author

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

As an adjunct professor, Jessica teaches feature writing and writing for magazines, most recently at Seton Hall University. She has taught at the graduate level as part of New York University's Science and Environmental Reporting Program (SERP).

She is a graduate of Columbia Journalism School, where she completed a mid-career masters with cross-disciplinary graduate studies in immunology, microbiology, and infectious disease. She lives with her husband and daughter in New Jersey.

Reviews

[Emily · Rating 4 out of 5]

What a fantastic book to read while sick! When I started Good Germs, Bad Germs, I had just come down with a respiratory tract infection, and by the time I finished it I had succumbed to a feisty gastrointestinal virus, along with the majority of my family. I lay in bed, imagining staphylococcus aureus leaving its "sweet spot" in my nose and dripping down into my lungs, where it could colonize and cause pneumonia. I noted my bad breath and imagined the streptococcus mutans lining up shoulder to shoulder in my dental plaque, and promised myself I would drag myself out of bed to dislodge them, no matter how ill I felt. I pictured whatever microorganism causing my nausea multiplying rapidly and excreting their nasty byproducts until finally, when my stomach lining reached its toxic threshold, I expelled it all (over and over again. For 12 hours.) Now I am imagining how the landscape of my digestive tract is riddled beyond recognition, the virus having expunged all the protective bacterium that normally call it home. I'm eating yogurt, full of probiotics, trying to repopulate my guts with helpful lactobacilli, so that someday I will be able to properly digest food again. I'm hoping and praying that my natural ecosystem will balance itself out in my favor, soon.

The premise of this book is scary stuff. While we are so, SO fortunate to live in this day and age of sanitation, vaccines, and antibiotics -- the American life span has more than doubled since 1776 -- it seems we are starting to pay the proverbial piper. We in the developed world have increasingly high rates of inflammatory and autoimmune diseases (atherosclerosis, arthritis, diabetes, lupus, MS, etc.,) allergies (both disturbing and life-threatening,) and even depression, all of which were almost unheard of before the 1800's and advent of public sanitation (waste collection, sewer systems, refrigeration, etc.) People in undeveloped areas of the world rarely suffer from these maladies. Of course they also may still die from dysentery or cholera, and before the age of 50, but it is what it is -- have we traded quality of life for quantity of life?

Antibiotics -- stop abusing them! Please, please PLEASE do not ask your doctor for antibiotics when you have a cold. Or even the flu, usually. Antibiotics kill BACTERIA, and the majority of every-day illnesses are caused by VIRUSES. If you take antibiotics when you are suffering from a viral infection, a couple things will happen: 1. You might feel a little better, possibly via placebo effect. But! 2. Your antibiotic will kill lots of bacteria that are beneficial to your body, particularly your digestive system. 3. It can cause antibiotic-resistance among any remaining bacteria, which may prove problematic later on, because apparently bacteria can swap genes and practice all kinds of unfair warfare when they want to dominate. And this will not only affect you and your body, but EVERYONE. I have always known somewhat about antibiotic resistance, and tried to do my part by not using them indiscriminately, finishing my course, etc., but I have naively thought that because I wasn't personally abusing them, they will work for me someday when I need them. Not so. Due to widespread human and agricultural use (DON'T GET ME STARTED ON AGRICULTURAL USE!) virtually every antibiotic out there has encountered resistance, and these antibiotic-resistant bacteria show up EVERYWHERE, even in people who haven't taken antibiotics for years.

Oh, the fear! MRSA ("flesh-eating bacteria",) sepsis, pneumococcal pneumonia, massive infections shutting down organs! Fortunately, the last part of this book gives a little hope. While researchers are every trying to develop new antibiotics, the real promise looks to be in the field of PRObiotics. Our bodies are covered in microbes from the second we are born, and our health depends on the good ones that muscle out the bad ones. If we can promote the growth and colonization of beneficial microbes, there will be no room for the diseases-causing ones. I love one of the last chapters in the book that quotes microbiologist David Thaler, who imagines that we will soon stop waging warfare on germs via all our hand-sanitizers and lysol wipes, and instead deliberately seeding our environment with carefully selected strains and species. "We will no longer douse our hands, faces, and bodies with antibacterial soaps; we will wash them with probiotic mixtures shown to enhance health…. Instead of futilely trying to disinfect public bathrooms, cleaning crews will spray toilets and doorknobs with tenaciously territorial "good" bugs. Subway straphangers will grab onto handholds impregnated with bacteria that kill cold and flu viruses on contact." (pg. 215)

Good Germs, Bad Germs: Health and Survival in a Bacterial World was published in 2007. I don't know how far some of this research in probiotics has gone in the past seven years, but I am hopeful. I do know that our FDA causes everything to move at a snail's pace, so in the meantime, I'll be doing my best not to get sick. (Again.) And as a side note -- this book makes no mention of nutrition, but it's been proven since the time of plagues that those with the best nutrition stand the best chance of survival from all kinds of pestilence. Eat your vegetables!

[Michael · Rating 5 out of 5]

This is a book every human alive should read. Yup, I feel that strongly about it. It is an enlightening read that makes one appreciate the complex mechanisms of the human immune system as well as the ongoing relationships humans have with bacteria. The book reads easily, with real-world anecdotes setting up each chapter's examination of how science has revealed the problems and potential solutions to varying issues.

The book essentially examines humans' relationship with the bacterial world past, present and future. It does not attempt to address any higher or lower level organisms such as fungi or viruses. After reading this, you will understand why the bacterial world is such a significant factor in humans' health. We cannot live without bacteria integrated into our internal ecosphere!

Bacteria have been around for billions of years. That's much longer than multi-cellular life never mind mammals or humans. Humans (as have all other higher life forms) evolved in a world dominated by bacterial life. Our complex systems are tuned to co-existing with the bacterial world, both within us and in our external environment.

The human organism developed natural defenses against bacterial invaders. When humans became "civilized" (gathering into fixed societies from their hunter/gatherer roots) they availed bacteria of an opportunity to develop mechanisms to circumvent humans' defenses. And so scourges literally plagued humankind. In response, humans evolved (by natural selection) to have a hyper vigilant immune system ready to spring into action against the constant onslaught of bacterial invasion.

Along came modern times and humans cleaned up their act, again literally. Sterilization, sanitation and finally antibiotics pushed back the constant onslaught of bacterial assault. However humans still have immune systems on a hair-trigger and this may contribute to why auto-immune syndromes have become so prevalent, particularly in the developed world.

Bacteria naturally quickly evolved "workarounds" to the antibiotics and thus we have anti-biotic resistant bacterial infections on a rapid rise. One of the most fascinating chapters in the book discusses bacterial have gone about circumventing antibiotics and how they freely share their "tricks" with other bacteria, even of other species!

The book examines how the increasing use of multi-antibiotics (that attack using many different chemical weapons) lay wholesale waste to the entire landscape of bacterial fauna within our systems, both good and bad. Killing the good bacteria leaves plenty of room for the resistant bad bacteria to take a firmer footing and so frequently it’s actually counter-productive to use such drastic recourse.

The book discusses the future of fighting bacterial infections – and it’s heartening to know that science does indeed have many clever arrows left in its quiver - they are more strategic than brute force as we learn more about how humans interact and rely upon the microbial world. I leave it to you to read the book to discover the wonder and very very scary mechanisms currently being worked upon – suffice it to say that as science develops weapons against singular bacterial assaults on humans we are simultaneously enabling easy access to developing very very potent biological weapons that can be used against large populations without hope of stopping them.

[rach · Rating 4 out of 5]

this was an incredibly interesting read, especially after having finished a semester of genetics and immunology. a lot of really interesting takeaways regarding our relationship with the bacterial world and how we can utilize it to alleviate some of the issues people are really afflicted with today. i'd be curious to hear about updates regarding some of the studies mentioned, since this book and its contents are over 10 years old. only reason didn't give 5/5 is that sometimes it got a bit too technical, and i'm not really a microbio person.

[Tracey · Rating 4 out of 5]

Good Germs, Bad Germs: Health and Survival in a Bacterial World, by Jessica Snyder Sachs, is an exploration of humans' interactions with bacteria throughout time with an emphasis on modern history and developments of the twentieth and twenty-first centuries, such as the widespread use of antibiotics in people and animals for both therapeutic and non-therapeutive, or preventative, measures.

The book's prologue begins with a narrative about Ricky Lannetti and his battle with antibiotic resistant MRSA, a particularly destructive strain of Staph. This narrative begins Sach's exploration of how humans and bacteria coexist and how this once symbiotic relationship of man and bug is transforming with the development of new antibiotics and evolving bacteria.

Sach explores stories of patients infected with bacteria, patients who use bacteria as part of a CAM (Complementary and Alternative Medicine) treatment, doctors who developed and are developing new antibiotics, food companies exploring the use of probiotics in their products, and microbiologists who are discovering how bacteria evolve, share information, and develop antibiotic resistance.

Unlike many non-fiction science books, such as The Brain That Changes Itself, Good Germs, Bad Germs is organized into seven distinct parts plus a very brief coda, rather than the standard chapters that readers have come to expect.

Sachs' book begins with a brief glossary of seven key terms used throughout the book. The glossary explains these sometimes complex parts of scientific jargon in laymen's terms.

Each of the seven parts in the main section of the book are well-organized and each part includes specific and well researched examples with copious supporting endnotes.

The glossary, coupled with Sachs' accessible writing and concise well titled sections within each part, makes her ideas available to readers of all levels and backgrounds. A specialized advanced degree in science isn't necessary to enjoy reading Good Germs, Bad Germs.

This book is recommended for anyone concerned with the proliferation of antibiotics in our bodies and in our food. Hopefully this book will allow patients to make better informed decisions regarding their use of broad spectrum antibiotics for common ailments and maladies.

Good Germs, Bad Germs is also recommended reading for high school and college students considering majors or careers in the biological sciences, specifically microbiology.

[Elizabeth · Rating 5 out of 5]

We truly live in a bacterial world. They live in the soil on which we walk, they swim in the water we drink, and they even float on particles of dust in the air we breathe. And for every human cell in our own bodies, there are ten bacterial cells, on our skin, in our upper respiratory tract, and all throughout our gastrointestinal tract, making up the human microbiome. Not only are these bacteria harmless to us, they’re actually healthy for us: industrial agrobusiness raises their animals on antibiotics because it causes them to gain weight, and when Louis Pasteur tried to raise mice under sterile conditions, they all died.

Which is not to say that we should throw out our antibiotics, stop washing our hands, and drink raw milk, because there are a few strains of Staphylococcus aureus, Listeria monocytogenes, Clostridium difficile, Enterococcus faecalis, Salmonella typhimurium, Shigella dysentariae, and Streptococcus pyogenes that can, and do, make us very sick and even kill us. The problem, however, is that when you use an antibiotic to take out a dangerous bug like Strep, you also raze your microbiome and leave yourself at the mercy of whatever bugs happen to be resistant to the drug you chose. As Rockefeller University microbiologist David Thaler says, “Whenever you make a sterile surface, you become a victim of whatever falls on it. It’s like plowing a field and not planting anything but instead trying to live on whatever weeds happen to pop up.”

The HIV field learned hard lessons about the dangers of serial monotherapy and have essentially solved the problem (in rich countries, at least) with HAART (highly active anti-retroviral therapy), but even if antibiotic-prescribing physicians learned the lesson to never give antibiotic monotherapy, additional challenges remain. Horizontal transfer of resistance genes among bacteria is very easy, so bugs in the microbiome naturally resistant to a couple of the drugs in the combination (and there are so many bugs in the microbiome that the probability of such a bug being resident, certainly among a population of humans, is not so remote) develop resistance to the remaining monotherapy in the conventional way, but then can pass all three resistance genes to any other passing bug, benign or pathogenic. Furthermore, although we frequently blame the development on antibiotic resistance on pushy mothers for demanding antibiotics for viral infections or on children for prematurely stopping taking their prescription, the fact remains that 89% of the antibiotics used in this country are consumed by livestock, and the vast majority of those are not given to sick animals, or even to prevent infection, but given at subtherapeutic doses because, for reasons of which we’re not entirely certain, they promote faster growth (possibly because the livestock’s microbiomes are getting trashed). Not only does giving subtherapeutic doses to healthy animals (of, in many cases, the very same drugs also prescribed to human patients facing life-threatening infections) produce an ideal laboratory for the production of antibiotic-resistant microbes, but this problem is exacerbated by the fact that farms do not face the same strict regulations for processing animal waste as municipalities do for processing human waste, so that antibiotic-resistant microbes, unmetabolized antibiotics, and plasmids containing antibiotic-resistance genes end up in the environment surrounding these farms.

As long as our therapeutic strategy is to kill bacteria, any drug we produce will inevitably select for resistance to that drug (even in people who don’t believe in evolution). One other, far more effective approach is to use the good germs to help us fight the bad ones. As far back as 1958, New York Hospital was able to eradicate a seemingly-intractable Staph. aureus 80/81 epidemic, one that had didn’t flinch at any of the best antibiotics available, merely by proactively inoculating newborns with a different strain of Staph. aureus: the good Staph eliminated the bad Staph. The treatment was cheap (they merely took a nasal swab from a nurse who, doctors observed, had much better luck with the babies she took care of than any of the other nurses did), had no observable side effects, and prevented countless deaths. Why don’t we currently embrace the microbiome transplant as standard therapy and not as a treatment of last resort? Good question.

The benefit of good bugs goes beyond merely crowding out the bad bugs. The “hygiene hypothesis” proposes that many diseases that have been rising in the last couple of centuries are a result from sudden alterations in the microbiome, with whom our immune system has been evolving for millions of years, caused by changes in hygiene, far too recent on an evolutionary scale for our immune system to adapt to. These diseases include not obviously auto-immune diseases, such as serious food allergies and ulcerative colitis, but, some researchers propose that stimulating a patients immune system with a Mycobacterium vaccae vaccine can cure not only autoimmune diseases such as Raynaud’s syndrome and peanut allergies but also diseases whose connection to the immune system is less obvious, such as metastatic melanoma.

No doubt the Dr.s Stanford had a great idea with their M. vaccae vaccine, no doubt they are charming individuals, and no doubt the patients who go to them for the monthly “dirt vaccine” (something that is apparently legal in England) are grateful for feeling better, but the author seems insufficiently skeptical. The patients who came to the Dr.s Stanford for their dirt vaccine, for whom it was ineffective in curing their cancer, are now dead and unable to speak up. The clinical trial designed to test the hypothesis of whether the vaccine actually makes a difference among lung cancer patients showed that it did not. This is why we have clinical trials.

To be fair, if I had inoperable metastatic melanoma, I too would probably start trying crazy therapies like dirt vaccines, and then if my cancer suddenly went into remission, I probably would not say, “Oh, it must have been a coincidence”. We, as humans, are of course all biased. The author, perhaps recognizing that, takes precautions to help strengthen her objectivity: incredibly meticulous, yet unobtrusive, endnotes, one of the greatest features of this book and one that is sadly lacking among too many pop science books. If I think, for example, that the author gives insufficient weight the clinical trial mentioned above, I can look up endnote 64 in Chapter 3 to find the citation in Annals of Oncology, and then head to the library to read the study myself and see whether or not it had the design flaws that the Dr.s Stanford claim. In the same vein, I can look up endnote 65, in which Dr. Stanford claims the supposed benefit among adenocarcinoma patients, to read “John Stanford et al., ‘Successful Immunotherapy with Mycobacterium vaccae in the Treatment of Adenocarcinoma of the Lung,’ unpublished”, and then give that the consideration I think it is due. In this way, if I feel that Jessica Snyder Sachs is at any point insufficiently critical, she has given me the tools to go read the evidence and judge for myself. Not only does it make her book that much stronger, but also it reinforces the point that science is not knowledge handed down from God (as so many science textbooks make it seem to be): every sentence in a science text results from observations, hypotheses, experimentation, and testing, and also plenty of heated arguments. As one of my biology professors from college said, “Every sentence in your textbook has blood behind it.”

And that’s what makes this book a great pop science book. Not only is it on a fascinating subject and carefully researched, as most pop science books are, but it also successfully conveys what science is all about.

[Joel Justiss · Rating 2 out of 5]

Sachs focuses on the use of antibiotics, probiotics, and related techniques to treat bacterial diseases. I was a little disappointed, because I was hoping for a broader-scale discussion of the ecological roles of bacteria in general. It was interesting, nevertheless, to read about probiotics (the administration of beneficial or harmless bacteria to inhibit the growth of harmful species), genetic manipulation, and other new techniques. Much of what Sachs reports is research and experimental treatments, so the change in health care approaches that she’s looking for is mostly in the future.

230 Probiotics appear to ease several kinds of inflammatory disorders, including Crohn’s disease.

[Jeff · Rating 4 out of 5]

Very readable review of the field of microbiology focused on the bugs that live inside us humans. Loved the first half which taught me a lot of fascinating biology. The second half is more a review of current biotech efforts to battle antibiotic resistance and was somewhat choppy. The book also could use a set of color plates to show us pictures of these bugs. But I loved reading this, even on vacation (where I usually prefer fiction), it was a compelling story.

[Anatoly Maslennikov · Rating 4 out of 5]

Наконец-то нашел книжку, где нормально написано и про устойчивые к антибиотикам инфекции, и про про то, что аллергии и прочие аутоимунные у людей развились от чрезмерной чистоты, и другие темы.

[Juliana · Rating 4 out of 5]

Чудова книга для прочитання у час COVID-19. Вона дає глибокі знання та розуміння мікробіому в історичній перспективі. Дуже цікава інформація про ріст вживання антибіотиків, особливо наскільки багато ми споживаємо через м'ясо та тваринні продукти. Мінусом є те, що книга 2007 року, відповідно наука вже відчутно просунулася вперед за цей час.

[Ганна Кузьо · Rating 4 out of 5]

Я біолог і чимало речей про міроорганізми вже знала. Як-не-як мікробіологія в нас була, хоч ми, екологи, і не вивчали її так детально, як наші однокурсники біологи. Проте для мене тут чимало нового. Навіть відомі факти подані з цікавими деталями, що стосуються наукових досліджень та клінічних випадків.

Якщо у вас не має біологічної освіти, то ця книга буде для вас можливо й відкриттям у багатьох питаннях. А питання ці стосуються нашого здоров'я та життя:

- гігієна

- інфекції та захворювання

- стерильність

- алергії

- вакцинування

- антибіотики

Дуже раджу для саморозвитку. Це не думка блогера, це збірка висновків наукових досліджень та клінічних історій. До прикладу люди, які не хочуть вакцинувати себе та своїх дітей, наражають їх на ризик страшних хворіб. Для лікування ж ці самі люди використовують антибіотики, які, м'яко-кажучи, значно більше шкоди та ризиків несуть, ніж вакцини. Чому люди роблять такий дивний вибір? Найчастіше через брак знань. Так от - будьмо розумні!

Антибіотикам присвячена велика частина книги, і якраз її мені було найбільш моторошно читати. Я звісно ж і раніше знала про проблему резистентності бактерій до антибіотиків. І про те, що через повсюдне використання антибіотиків коли треба і не треба ми прискорюємо еволюцію бактерій, залишаючи найстійкіших. Нюанс в тому, що навіть якщо ви ніколи антибіотиків не приймали, такі стійкі бактерії існують навколо, особливо у лікарнях, і якщо ви заразитесь таким штамом, то питання, чи вилікуєтесь. Це як колективний імунітет при масовому вакцинуванні - хвороби "зникають". А при масовому вживанні антибіотиків усі колективно піддаються ризику зараження стійкими до антибіотиків бактеріями.



Дуже цікаво розписані дослідження алергій та захворювань, пов'язаних із стерильністю. Колись давно проблемою був бруд в побуті та лікарнях, який призводив до зараження та смертей. Зараз в розвинутих країнах - навпаки. Стерильність осель, шарахання від тварин, відгородження дітей від бруду та тварин створює додаткові проблеми для здоров'я. Є над чим замислитись.

В цій книзі висвітлюється поступова історія знайомства людства та науки із світом мікробів. Зміна поглядів та практик, наростання нових проблем та ризиків. Усе подано у вигляді історій з лікарень та лабораторій. Для мене суттєвим мінусом цієї книги є перенасиченість цими історіями, за якими іноді не видно висновків. Хотілося б, щоб головні тези кожного розділу були окремо виділені, бо їх щоразу потрібно робити самостійно. Так - це корисно для мозку, але для багатьох людей, яким складно розуміти наукові терміни та ловити суть досліджень, це може бути складно.

Водночас ці всі історій - це й сильна сторона. Адже починаєш усвідомлювати, скільки праці науковців та лікарів, скільки втрачених життів стоїть за досягненнями медицини, які дозволяють нам жити довше і краще. І ось попри це не розумію тих людей, які так зверхньо відмахуються від цього. Якщо знати якою ціною створені вакцини, що за ними стоїть, скільки життів забрали ці хвороби - невже й тоді люди відмовлятимуться від них? Та, можливо, антивакцинатори й не читають книг здебільшого) Або читають лише ті, які підтверджують їх точку зору.

Дуже важливо, що в книзі підіймають тему корисних бактерій. Нові дослідження показують можливість боротьби з деякими бактеріями не лише шляхом вакцинації чи антибіотиків, а заселення трансгенними бактеріями, які не несуть шкоди. На думку деяких науковців з часом людьский вид має здійснити прорив у стосунках з бактеріями аби вижити. Подібно до того, як наші предки одомашнили рослини та тварини, ми маємо освоїти й бактерії.

Коротше кажучи, якщо ви критично мислите і цікавитесь здоров'ям, то ця книга вам буде корисною.

[Sepideh · Rating 5 out of 5]

This book is all about bacteria and how we are getting super strains of bacteria that are resistant to antibiotics. It mentions how bacteria easily transmit certain functionality to one another through the little loops of DNA known as plasmids. There were a couple of other methods of DNA exchange that I forget. The book described the difference between gram-positive and gram-negative. It has to do with whether the bacteria has a hard cell wall, I think.

The book spent a long time discussing probiotics. This is a method of finding a harmless or helpful bacteria that competes with an existing harmful bacteria to drive out the more harmful bacteria. The problem with research in probiotics is that companies cannot make a ton of money in the process of discovering bacteria so they don't bother. If they over come that hurdle, FDA regulation is really crazy on the stuff. One of the anecdotes in the book described someone who had discovered a probiotic to protect teeth from cavities. He had to cripple it so that it would not survive outside of its host so he made the bacteria so that it needed a protein that was difficult to acquire. People using the product had to swish with a special mouth wash twice a day. Then the thing went to FDA trials. For his trials, he needed to find people who were toothless, didn't have children, whose partners were also toothless, and were under fifty-five. He found two. He had very good results with his two people, but you typically need more than two people in your studies.

While discussing sepsis, the book made vague mention of cytokine storms. This is why swine flu has affected healthy adults.

Anyway, I enjoyed this book a lot. It made me think a little more about medical regulation and what sucks about it. However, you can see the need for it and why bacteria that someone created in a lab might be treated as a bioweapon instead of a medical possibility.

It turns out that organic farmers who do not use antibiotics for prevention do use probiotics because certain things have been approved for animal use.

[Barbara · Rating 5 out of 5]

This is an essential read if you've ever taken an antibiotic. Jessica Sachs is a freelance scientific writer and she makes complex science understandable to a lay person. I can't remember all the bio tech companies or the names of specific bacteria but I can remember microflora, antibiotics and probiotics. The overall gist of this research addresses a world of over-use of antibiotics, resistant bacteria, and ways science is addressing the problem. To sum it up, all of us are a living system with many many good bacteria keeping us healthy. When we get too clean - using antibiotics that not only kill a bad bacteria but also kill good bacteria, we breed resistant bacteria and leave ourselves vulnerable to more bad bacteria. And it's not just us taking antibiotics but it's the entire food industry feeding antibiotics to animals that produce the menu served at the dining table. It's pretty complex but Jessica sums it up at the end saying a return to a more 'balanced' approach may be in the near future. To quote a quote by Lederberg, "...What's important is that we're better off aspiring to a relationship of symbiotic coexistence." I am so impressed with this author... people who can remember all the details and write in a way I can grasp the big picture is very impressive to me.

[F. Neal · Rating 5 out of 5]

This book is a very well researched and well written guide to our hubris as a species. Sachs lays out how our war against microbes has turned out to be more damaging to us than it has been to the microbes that we were fighting. She then explains in detail how a growing cadre of scientists are learning how to work with microbes to prevent and cure disease, rather than trying to eradicate them.

There is probably a great allegory in the book about how it is better to use an enemy's strength against it and the implications of that in modern geopolitics. But I'm not going to go there, because this is a book about science, and science in the public interest. Its worth the read for that. Pay close attention to how irrational fear and cautiousness on the part of world governments have prevented or delayed potential cures for inflammatory bowel disorders, juvenile diabetes, and even tooth decay.

[RachelAnne · Rating 5 out of 5]

I keep hoping that in some incarnation, Walt Whitman is aware of this book. The composer of "Song of Myself" really ought to bliss out over the idea that he was additionally a vast biome of complexly interlinked microbial life. The fascinating intricacies of microbial research are supplemented by heart-thumping urgency forced by growing antibiotic resistance and the very real threat of looming drug-resistant disease epidemics. All this throws into even greater relief the wonders of the long-unnoticed and unappreciated microbes that have so perfectly adapted themselves to numerous precise niches within the human body. Snyder Sachs goes on to explore the glorious possibilities--and terrifying potential fallout of probiotic medical treatments. AMAZING!

[Jaclyn · Rating 4 out of 5]

This book wasn't nearly as user-friendly as the last book I read on the topic (The Rising Plague). I might even warn that those without a scientific background may get lost frequently. I studied Neuroscience and I found myself re-reading sections on occasion due confusing language or inadequate descriptions and background, or even just convoluted organization. However, despite the author's more complicated, less straightforward writing, this book provided much more of a well-rounded look at all sides of the issue than did The Rising Plague (which addressed only antibiotics). I learned a lot and feel like between both books I have come away with a deep appreciation and understanding of the issues at play. Very, very interesting topic and I'm glad I plowed my way through.

[Jessica · Rating 4 out of 5]

This was a very well-written and not-too-technical science book. It brings in a human element and does a great job explaining antibiotic resistance. The theory that over-sanitation has led to an increase in allergies and auto-immune disease was well-argued and I think there is probably some truth to it. It was fascinating reading about some of the new probiotic treatments and other alternative medicine that is cropping up in an effort to combat antibiotic resistance.

[Dеnnis · Rating 5 out of 5]

First book on germs and microbes we live with that is not freaking the ghost out of you from the onset. Rich with newest data, but also provides a very nice and brief introduction into the history of microbes hunt. Accessible, enlightening and outlook expanding.

[Tania · Rating 4 out of 5]

Книга змушує по-іншому глянути на мікроби, а особливо на нашу власну мікрофлору. Це неймовірна система, яка вражає, захоплює і трохи лякає.

Багато уваги приділяється темі резистентності до антибіотиків. Це важливо, адже це жахлива проблема сьогодення. Читати про те, як бактерії вчаться і мутують, створюючи нові штами насправді моторошно. /Люди, перестаньте безконтрольно пити антибіотики!/

Цікаво було прочитати про трансгенні пробіотики, оскільки вони відкривають багато перспектив для широкого застосування і насправді можуть стати нашим порятунком.

Словом, світ мікробів страшний і захоплюючий.

Щодо самої книги, то вона не дуже легка в прочитанні. Я її кидала декілька разів, але думаю, що просто треба було змінити підхід і читати меншими порціями, але регулярно. І не намагатись зрозуміти якийсь невдало написаний абзац перечитуючи його знову і знову, а просто читати далі. На жаль, є моменти, які написані не дуже зрозуміло.

В книзі зібрано дуже багато досліджень, але чомусь використана література не додається. Це мінус.

Дізнавшись, що книга вийшла в 2007 році (видана в нас через 11 років, що теж дивно, враховуючи її тематику), я трохи розчарувалась, бо за ці роки наука вже могла зробити величезний крок вперед і дослідження, які включені в книгу, можуть бути не такими вже й актуальними. Але вони теж частина історії і насправді вражають своїми першими результатами. Було б цікаво дізнатись, чи вони мали якесь майбутнє. Для цього було б корисно мати список наукових статей. *якого немає 😒

[Віталій Роман · Rating 5 out of 5]

Потужно. Трохи складно, якщо ти не біолог, але воно того варте. Обов'язково для прочитання, якщо хочете бути в "темі" коли настане момент вибору за/проти вакцинації, за/проти антибіотиків, за/проти продукції тваринництва, що вирощується "прискореними" способами. Особливо раджу батькам, які мають дітей. Книга не приймає ту чи іншу сторону, вона просто каже як є. На додаток, книга гарно написана. Поєднує наукові частини з історіями реальних людей, навіть з флеш-беками

[Islomjon · Rating 4 out of 5]

Author of the "Good Germs, Bad Germs", Jessica Sachs, has opened a new insight into the things how an ordinary person live unawared. She has written very clear and neat work in explaining how bacterias and germs surround us and, apparently, live in us. Describing a huge array of 'good' and 'bad' germs, she had successfully used a simple language for an untrained person.

[Олена Осіпова · Rating 5 out of 5]

Це книга про Всесвіт, який на мільйони років старший за людину. Зрозуміло, що жителі цього Всесвіту значно краще пристосовані до виживання, аніж ми. І що цікаво - вони без нас гарантовано виживуть, тоді як ми без них - дуже малоймовірно.

Взагалі, дуже цікаво і пізнавально, особливо якщо перед прочитанням трошки освіжити в голові базовий шкільний курс із біології.

[Ihor Kolesnyk · Rating 4 out of 5]

Багато цікавих і не дуже фактів, інформації, кейсів. Типова науково-популярна книга, але цього разу про мікроби для широкої аудиторії.

[Violetta K. · Rating 3 out of 5]

Книжка хороша і цікава, але я люблю більш наукове викладення. Якщо ви хочете почитати про біологію у форматі цікавого сторітелінгу у м’ясорубці прізвищ, біл��шість яких не будете пам’ятати потім — це точно ваш вибір.

[Ali · Rating 4 out of 5]

This book was assigned as a microbiology class reading. Now that I finished it, I can say it was the perfect candidate.

Bacterial and fungal diseases had been wiping out people until the later half of the 19th century with the constitution of "Germ Theory" by the highly-intelligent, Louis Pasteur, who finally solved the puzzle and established the link between many diseases and their "causing seeds". This work was further amplified and carried out by other great scientists such as the Nobel Laureate, Robert Koch.

Since the time of Pasteur, who is not included in this remark, we've had this frame of understanding of bacteria as invisible agents who just can't wait to get us! Since we knew of their presence, we've dedicated most of our scientific inquiry to finding out ways of eradicating those ruthless tiny creatures. Our major success was achieved with the discovery of antibiotics (Alexander Fleming and his Penicillin). We rejoiced thinking that we prevailed, the Homo sapiens, over streptococcus, staphylococcus, clostridium, and many other bugs! However, we forgot that there was a flip-side to that coin.

Sachs in her book challenges our current view of the microbial world and offers a pretty sophisticated alternative. What many of us don't know, as Sachs notes, is that bacteria and other microbes aren't all "bad". Our own bodies are microfloras to massive populations of bacteria that happen to be mostly non-harmful, if not useful. When we celebrated antibiotics, we forgot about things such as that bacteria are live organisms that are capable of replicating and evolving at extremely high rates. Our synthetic antibiotics are very powerful at eliminating diseases, but they are also nondiscriminatory in their targeting of microbes: they wipe out the bad ones with the good ones (which constitute the most).

Now what's the problem with that, you say? Well, bacteria, just like any other organism, exist within population that are mostly non-harmful. However, there are minorities that happen to be pathogenic. Such minorities are resistant to our antibiotics, so they survive. Their mere presence in our bodies isn't a threat because their toxicity is a population-dependent action, and because their "good" kind keep them in check. Therefore, when you wipe out most of the population, only the resistant survive replicating and reproducing more and more until they reach sufficient numbers to cause infection. Well then, what do you do? You treat them with more antibiotics, right? but I just told you they're resistant to them, smarty, and you have cultivated that resistance! There you go! I just laid out to you our story of antibiotics which resistance to underlies many deadly infections that modern medicine is helpless against!

Scientists and physicians now understand the risk generated by our non-discriminatory war against microbes. Now we know that we're gonna have to be smarter in our way of treating infections. One great idea that's been introduced is "probiotics" which are, simply, good bacteria used to tackle bad ones. Another great idea is confusing pathogens by manipulating their communications (quroum-sensing) and many great ones that have the potential of curing diseases without disrupting the world within us and outside: the bacterial world.

Jessica Snyder Sachs has a pretty good case to defend in this book. She's a great story-teller, also. The book cites many experts on the subject from the US, Europe, and elsewhere. If you're interested in microbiology, evolutionary biology, medicine, or just in how to live in a bacterial world, then this book is for you.

Bacteria and microbes have long lived on this planet. We're probably just a passing phenomenon in their evolutionary history. They have always been and they will be after we're gone. The better we accept this and understand it, the better our chances of survival in their world.

[Michael Connolly · Rating 3 out of 5]

Good Germs Protect Us From Bad Germs:
The good germs that live in and on us protect us from the bad germs, similarly to the way good plants in a garden help prevent weeds from growing. The good germs use up the nutrients so that they are not available to the bad germs. They also change the chemistry of their environment, making it inhospitable to pathogens. Babies initially acquire symbiotic bacteria from their mothers, at birth and when nursing, and later when they inhale air containing bacteria-laden dust particles.

Hygiene Hypothesis:
The hygiene hypothesis is the idea children had less asthma, hay fever, eczema and other allergic diseases in the dirty, old days, when they were exposed to more microbes and intestinal parasites that helped teach their immune systems not to over-react to harmless antigens. Some symbiotic bacteria stimulate the body to produce the kinds of cytokines, such as interleukin-10, that calm the immune system.

Problems Caused by Overuse of Antibiotics:
Antibiotics kill our intestine’s friendly flora. This can lead to digestive problems, and infections, such as Candida albicans. Antibiotics kill those bacteria of a strain that are susceptible to it, leaving bacteria with drug-resistance genes to thrive and multiply. Drug resistant genes can arise from mutation, but more often these genes are acquired by sex with other species of bacteria that already have these genes. Antibiotics given to farm animals produce drug-resistant pathogens that sometimes find their way into humans.

Rapid Diagnosis Enables Focussed Antibiotics:
Doctors often prescribe broad-spectrum antibiotics, because they don’t have time to wait two or three days for the patient’s bacteria to be cultured. But broad-spectrum antibiotics suffer from the defect that they also kill good bacteria. Scientists are working on rapid diagnostic tests that will identify the species of bacteria in only a few hours. The doctor can then prescribe an antibiotic that kills only the pathogen.

[Angela Boord · Rating 5 out of 5]

Since this book was written seven years ago, the information in it undoubtedly needs to be updated, but it is also depressing to realize how much remains the same: doctors are still over-prescribing antibiotics and the use of probiotics to treat (or prevent) disease is still considered fringe for the most part (although I think that everybody now knows that the bacteria in yogurt will help your digestive system, thanks to those Activa commercials.) And nowhere have I heard that probiotics will help moderate allergies -- which is my own experience -- or that there is solid science and success in treating autoimmune disease and even cancer with probiotic bacteria. Alternative health sites on the Internet do promote the use of probiotic foods to cure all ills, but their claims are often sorely lacking the science to back them up. This book gives you the science, and also helps to weed through the hype that is out there.

It isn't a diet and self-help book; it's a piece of science writing for a popular audience. As such, it takes a lot of complicated science and makes it understandable. It's also a terrifying book in many ways, because it documents the rise and spread of antibiotic infections such as MRSA and C.difficile. So if you're the sort of person who is terrified by reading about that sort of thing, you might want to approach this book in small doses. But I think it *is* still an important book to read, perhaps in conjunction with a newer book such as Missing Microbes (2014).

[Dennis Littrell · Rating 5 out of 5]

Thoroughly professional; a little scary

I've read a number of books on microbes in recent years, including

Bakalar, Nicholas. Where the Germs Are: A Scientific Safari (2003)
Biddle, Wayne. A Field Guide to Germs, 2nd ed. (1995, 2002)
Ewald, Paul W. Plague Time: How Stealth Infections Cause Cancers, Heart Disease, and other Deadly Ailments (2000)
Heritage, J., and E. G. V. Evans, R. A. Killington Microbiology in Action (1999)
Karlen, Arno. Biography of a Germ (2000)
Murray, Patrick R., et al. Medical Microbiology (2002)
Oldstone, Michael B. Viruses, Plagues, and History (1998)
Shnayerson, Michael and Mark J. Plotkin. The Killers Within: The Deadly Rise of Drug-Resistant Bacteria (2002)
Tierno, Philip M. Jr. The Secret Life of Germs: Observations and Lessons from a Microbe Hunter (2001)

What sets science journalist Jessica Snyder Sachs' book apart from these fine books is the intense detail and focus that she brings to the work and the fact that her book is up to date with reports from the latest research. Written for a general educated readership, it gets a little dense at times and there's a lot to keep in mind and to understand. But I think the time and effort are worth it. I must warn you however, it does get a little scary. If you are prone to hypochondria or to paranoia, I would suggest you skip reading this since it appears that we are teetering on the edge of any number of possible microbial disasters.

At the same time there is also the promise of a level of understanding of how drugs, bacteria and our immune systems work together, or are at odds, that will lead to healthier lives for all of us.

Some of the topics covered:

--A bit of the history of medicine before the germ theory of disease rose with Pasteur to the balmy times circa 1960 when some authorities were predicting the end of infectious disease, to the rise of antibiotic resistant bacteria that characterizes today's world.

--The interaction between bacteria in our intestinal tract and the fact that we could not digest our food or even live without the benign bacteria that help us. Sachs quotes Nobel laureate Joshua Lederberg in this regard: "'It would broaden our horizons if we started thinking of a human as more than a single organism. It is a superorganism that includes much more than our human cells.' Lederberg calls this cohabitation of human and microbial cells the 'microbiome...'" (p. 238)

--The "hygiene hypothesis," in which certain diseases such as allergies, asthma and immune system disorders are thought to arise because we keep our homes too clean, and our children do not have the exposure to common germs early and often enough to build up a proper immune response. In the case of allergies and autoimmune diseases, apparently exposure when very young to would-be allergens "teaches" the immune system to regard them as harmless. Without this exposure the immune system may go wild. Sachs' treatment of this murky subject is the best I have read.

--Bacterial mutations, including the exchange of drug resistant genes between species within our intestinal tract. (Bacteria do have sex on occasion!) This rather sobering part of the book explains how bacteria manage to elude our best defenses and prescriptions. Implicit is the fact that we do indeed live in a bacterial world that has in toto a greater grasp of biochemistry than perhaps we will ever have. They've had two or three billion years to perfect their defenses, so we have our work cut out for us.

--Various new methods of dealing with microbes including new drugs, infecting bacteria with viruses, inculcating ourselves with good bacteria to keep the bad out, bioengineering new benign strains to replace the dangerous ones. This approach is called "probiotic," that is, "proactively replacing the body's trouble-prone bacteria with strains and species of our choosing, even of our own making." (p. 193)

--Enhancing the immune system so that it better fights harmful microbes while at the same time leaving its own tissues alone, checking inflammation and autoimmune disease.

Some interesting info:

Our intestine when empty of food harbors about 15 trillion microbes; when full, perhaps 100 trillion! (p. 44)

Babies typically get their first intestinal bacteria by riding face down out of the womb, picking up a bit of the inhabitants of mother's stool. (p. 53) Babies delivered by caesarian section have more allergies than vaginal birth babies and may have a tougher time setting up a stable flora in their digestive systems. (pp. 99-100)

It is now clear that healthy tissues in our bodies are not necessarily microbe-free. In fact, I learned here that the way the immune system works sometimes is to ignore resident bacteria that are not causing any trouble. Furthermore, our immune systems can get used to some pathogens and just leave them alone after awhile. In fact sometimes real trouble starts when the immune system goes into high gear and tries to rid the body of every last germ. A case in point is the plaque build up in the arteries of some people in reaction to the presence of harmless bacteria. In other people the immune system doesn't respond and there is no plaque build up leading to heart attacks.

The fact that "it's not bacteria that wreak the deadly damage of sepsis, at least not directly." Instead, it is "a person's own immune system...." (p. 221)

This is an outstanding book, engagingly written, meticulously edited and proofed, with a plethora of endnotes and an excellent index.

--Dennis Littrell, author of “The World Is Not as We Think It Is

[isbjørn · Rating 3 out of 5]

Boken begynte begynte veldig, veldig bra. Veldig finn innføring i hvordan man har sett på bakterier, antibiotika og probiotikia gjennom medisinens historie, hvordan det hele henger sammen med antibiotikaresistens, allergier, etcetera. Masse fotnoter og konkrete referanser - jeg stoler på forfatteren - og lærte masse. Detaljert og nerdete.

Men de siste delene, som forsøker å peke ut hva som kan skje i fremtiden, ble rett og slett kjedelige. Uprioritert og hoppet veldig fra det ene til det andre, og såpass detaljert at det blir vanskelig for en lekmann å følge med.

[Jessica McReaderpants · Rating 5 out of 5]

This is an amazing and highly interesting book. It explaines the why of antibiotic resistance and the science behibd it. Very interesting and extremely pertinent for Anyone, esp young doctors and nurses. Itgoest into phages, reverse vaccine construction, probiotics, etc. i cannot say how very intreiging this informaion is. I superduper enjoyed this and give it the elusive 5 stars that it totally deserves.

[Alyssa A · Rating 5 out of 5]

Awesome. Really interesting stuff--presents a whole new perspective on how we deal with bacteria in a world where cleaning products boast of killing 99.9% of germs. "Good Germs, Bad Germs" presents the idea that killing 99.9% of germs may actually be a bad idea--a large percent of these germs are actually beneficial to us, and focusing more on harmony and balance between good and bad germs might need to be our new tactic in the battle against microbial disease.