Missing Microbes

Starred review from February 17, 2014
Humans are losing “ancient microbes” from the overuse of antibiotics and medical practices like Caesarian sections, warns Blaser, director of New York University’s microbiome program and a researcher whose study of one pesky pathogen, H. pylori, helped lead both to the discovery of its link to ulcers, and to the troubling changes triggered by early-life exposure to antibiotics. The average American child receives nearly three courses of antibiotics by age two and has about 17 courses by age 20, Blaser writes. But we pay a devastating price for this assault on the “invisible zoo living on and inside” us: rising rates of obesity, asthma, diabetes, celiac and Crohn’s diseases, and quite possibly, autism, he says. There may come a day where we make peace with H. pylori, reintroducing it to the human microbiota, along with other banished organisms. In the meantime, Blaser urges doctors to curtail the use of antibiotics and use narrow-spectrum drugs instead; to limit C-sections to cases necessary to save the life of mom or baby; and for farmers to end to the use of antibiotics on animals whose products we eat. It’s an engrossing examination of the relatively unheralded yet dominant form of life on Earth.

March 1, 2014
Infectious disease specialist Blaser makes an impassioned plea for maintaining the biodiversity of the ecosystem that exists in and on our bodies: the human microbiome. That microbiome consists of 10 trillion bacteria, fungi and viruses, and it's a life-support system we depend on to metabolize foods, make vitamins, outcompete pathogens and bolster immunity. Blaser claims that we are killing the system with overuse of antibiotics, hand sanitizers and increased cesarean births, which eliminate babies' baptism by bacteria as they pass through the birth canal. The result is a shrinking of diversity, shifts in the ecosystem and a dangerous rise in antibiotic-resistant pathogens. The author is no foe of antibiotics; indeed, the drugs once saved him from death from typhoid fever. However, he deplores the all-too-easy reach for the prescription pad to treat nonserious (and nonbacterial) runny noses and colds, not to mention the dosing of farm animals with antibiotics to promote rapid growth and weight gain. Blaser concentrates on gut bacteria--the richest sites of human colonization--and uses the example of H. pylori, ancient acid-tolerant stomach bacteria found only in humans, to demonstrate that bugs can play both good and bad roles in human health. Eliminating H. pylori eliminates stomach inflammation (gastritis), ulcers and late-life risk of stomach cancer, but the species also generates hormones, helps regulate inflammation and modulates immune reactions. Blaser also has epidemiological data and intricate animal experiments to back up associations between antibiotics/changed microbiomes and inflammatory bowel disease, Type 1 diabetes, obesity, some cancers and even autism, with the suggestion that there are critical times in early development when even transient use of antibiotics can have lifelong effects. There's no denying that the diseases Blaser highlights are multifactorial in origin and that the hygiene-hypothesis folks have a point when they declare our hypersanitized world revs up our immune systems to attack us. Credit Blaser for displaying the wonders and importance of a vast underworld we are jeopardizing but cannot live without.

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Starred review from April 1, 2014
You share your body with a vast population of microorganisms. Ten trillion human cells coexist with 100 trillion bacterial cells. The human microbiomean elaborate ecology of microbes on us and within usplays a major role in health, especially immunity and metabolism. But this collection of mostly pacifistic and beneficial species of bacteria that coevolved with human beings is increasingly endangeredby excessive use of antibiotics in humans and farm animals, overutilization of antiseptics and sanitizers, and the rising rate of cesarean sections. Blaser, an infectious-disease expert and researcher at NYU, is convinced that the swelling number of people with obesity, asthma, and esophageal reflux is a consequence of disrupting the microbiome. He warns that even short-term use of unnecessary antibiotics in children can have long-term implications. Antibiotics have been available for almost 70 years and have saved countless lives. Surprisingly, however, around 70 percent of antibiotics in use are allotted to livestock to promote growth and fatten them up. Human microecology is complex, even paradoxical: the bacteria Helicobacter pylori can make folks ill (ulcers and stomach cancer) and keep them well (protection against GERD, asthma, and esophageal cancer). Blaser's Missing Microbes is a masterful work of preventive health and superb science writing.(Reprinted with permission of Booklist, copyright 2014, American Library Association.)

November 15, 2013

Director of the Human Microbiome Program at New York University, Blaser explains that bacterial and human cells have coexisted beneficially for hundreds of thousands of years. But now irreplaceable microbes are being lost to antibiotic treatments, resulting in increased incidences of obesity, asthma, diabetes, and some cancers. Immense in-house excitement.

Copyright 2013 Library Journal, LLC Used with permission.

Starred review from June 1, 2014

Considering our current obsession with antibacterial hand sanitizers and other cleanliness rituals, most people probably do not realize--or, frankly, want to know--that 90 percent of a human's cells are actually bacteria. That fact poses questions that challenge basic assumptions: Does that mean we are coexisting with these microbes? But aren't bacteria the enemy? Infectious disease specialist Blaser, who directs the Human Microbiome Program at New York University and founded the Bellevue Literary Review, has spent a lifetime studying bacteria and antibiotics and drawn some mind-bending conclusions--namely, that antibiotics may be increasing chronic health problems such as obesity, asthma, autism, and cancer. He takes the reader through the discovery of antibiotics, which have indeed saved millions of lives, and describes the unforeseen consequences of their overuse. He also describes a parallel line of scientific research delving into "good" bacteria and the complicated relationship between these life-forms and human health. VERDICT Blaser explains even the most complicated scientific and medical concepts with straightforward clarity. Most important, he makes a case for why readers, whatever their background, absolutely need to care about society's overuse and misuse of antibiotics. [See Prepub Alert, 10/21/13.]--Marianne Stowell Bracke, Purdue Univ. Lib., West Lafayette, IN

Copyright 2014 Library Journal, LLC Used with permission.

June 1, 2014

Considering our current obsession with antibacterial hand sanitizers and other cleanliness rituals, most people probably do not realize--or, frankly, want to know--that 90 percent of a human's cells are actually bacteria. That fact poses questions that challenge basic assumptions: Does that mean we are coexisting with these microbes? But aren't bacteria the enemy? Infectious disease specialist Blaser, who directs the Human Microbiome Program at New York University and founded the Bellevue Literary Review, has spent a lifetime studying bacteria and antibiotics and drawn some mind-bending conclusions--namely, that antibiotics may be increasing chronic health problems such as obesity, asthma, autism, and cancer. He takes the reader through the discovery of antibiotics, which have indeed saved millions of lives, and describes the unforeseen consequences of their overuse. He also describes a parallel line of scientific research delving into "good" bacteria and the complicated relationship between these life-forms and human health. VERDICT Blaser explains even the most complicated scientific and medical concepts with straightforward clarity. Most important, he makes a case for why readers, whatever their background, absolutely need to care about society's overuse and misuse of antibiotics. [See Prepub Alert, 10/21/13.]--Marianne Stowell Bracke, Purdue Univ. Lib., West Lafayette, IN

Copyright 2014 Library Journal, LLC Used with permission.