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June 15–July 27, 2020 22 Working Nurse l WorkingNurse.com BOOK CLUB by Christine Contillo, RN, BSN, PHN T here is probably nothing more terrifying than finding yourself in a remote area of a foreign coun- try with a desperately ill loved one. Add to that doctors who seem at a loss for answers and in no rush to find any and you have all the ingredients for a nightmare. That was exactly the scenario faced by UCSD epidemiologist Steffanie Strathdee, Ph.D., on a vacation in Egypt. When her husband's health suddenly spiraled out of control, she was faced with doctors who were unable to diagnose or treat the problem; Egyptian tourist police more concerned with avoiding "an incident" than helping; and a travel health insurance plan with no local agents, forcing her to deal with the company by long-distance cellphone. As her husband lost consciousness, Strathdee had to make some critical deci- sions. She assigned the rational part of her brain to tackle the problem while the emotional side was busy giving her hus- band support and contacting family. Had her husband's illness been readily treatable, that might have been enough, but things got more complicated when the doctors told her there were no combi- nations of antibiotics effective on his mas- sive superbug infection. Luckily for Strathdee, she had some advantages the average tourist doesn't: her scientific background, her training as an epidemiologist and a network of con- tacts from esteemed hospitals across the globe. She put on her research hat and went to work. A Biological Arms Race The ability of bacteria to develop resist- ance to antibiotics has been a known dan- ger since the 1940s. For most of the antibiotics now available, resistant strains have not only developed, but also gone global. Today, 1.5 million people are killed yearly by superbugs: multidrug-resistant infections. Bacteria with resistant genes have what amounts to "molecular chemical weapon- ry." They can produce enzymes to defend themselves against attack or even "hiber- nate" to avoid biocides. Unfortunately, humanity is falling behind in this biological arms race. No new class of antibiotics has been developed since 1980, and while what we have in our existing arsenal is still doing the job for now, bacteria continue to stay one step ahead. The story of Strathdee's husband's ill- ness is a thriller in itself, but this book is also a warning to global public health offi- cials to be proactive now. The authors call for expanded communicable disease reporting, more shared science among countries, more research and more steps to curb the problem at the root. That includes limiting the antibiotics fed to live- stock and paying more attention to struc- tural risks such as the contamination of IV tubing, catheters and NG tubes. We joke that hospitals are the worst places to get well, but the growing danger of drug-resistant bacteria and healthcare- associated infections can make that painfully true — and without a serious effort, the problem will only get worse. The Perfect Predator will have you reex- amining infection control policies and explaining to friends and relatives why it's a bad idea to demand antibiotics for a common cold. The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug by Steffanie Strathdee and Thomas Patterson (Hachette Books, 2019) _________________________________________ Christine Contillo, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions. WN The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug By Steffanie Strathdee and Thomas Patterson The dangers of antibiotic resistance Not the average tourist, Strathdee was an epidemiol- ogist with contacts at hospi- tals across the globe. LOSING THE BIOLOGICAL ARMS RACE No new class of antibiotics has been developed since the 1980s. Today 1.5 million people are killed by multi-drug resistant infections.