11/30/2008 - Three of the NFL's biggest stars have been tackled by something so small it can be seen only under a microscope. Cleveland Browns' star Kellen Winslow, Tom Brady of the New England Patriots and Peyton Manning of the Indianapolis Colts have been sidelined with bacterial infections this season, according to news reports.
These high-profile cases remind us that hard-to-treat bacterial infections are, unfortunately, part of a wider and more troubling trend.
For example, a particularly worrisome bacterial strain - methicillin-resistant staphylococcus aureus or MRSA - recently sickened students at Lakewood High School and at Mentor High School.
If you think that the bugs are getting tougher to beat, you're right. Bacteria are growing more resistant to the best options in the medical playbook, namely types of antibiotics that in past years could easily kill the germs before they caused serious illness or death.
The bugs are getting stronger because the drugs designed to fight them have been misused - not only on human patients, but also, it is now known, in large-scale livestock feeding operations.
Besides staph strains (including MRSA), other bacteria growing resistant to antibiotics include food-borne campylobacter, E. coli and salmonella.
Bacteria acquire resistance to antibiotics through prolonged exposure to low doses. Their biological systems learn to recognize the chemical mechanisms that antibiotics use, develop defenses that resist or evade those mechanisms, then include those genetic traits as they reproduce - spreading the drug resistance among entire bacterial colonies.
Some drug resistance stems from overuse in treating people. The common cold, for example, is caused by a virus, not bacteria, so antibiotics shouldn't be used to treat it.
But more than half of all antibiotics used in this country go to agriculture, mostly large-scale livestock feeding operations. There, some of the most potent disease-fighting drugs in modern medicine are routinely fed to livestock, not because they are sick with a bacterial infection, but just to make them gain weight faster or to compensate for crowded, stressful and un- sanitary conditions in factory farms.
Resistant bacteria from these farms then may be picked up by humans through contaminated meat, contact with farm or food workers who handle contaminated animals or meat, and by contact with soil or water polluted by farm waste.
Agricultural overuse of antibiotics has been directly connected to resistant campylobacter, E. coli and salmonella. Research is now under way into whether drug-resistant MRSA infections also can be traced back to misuse of antibiotics by large-scale livestock feeding operations.
Note that the problem doesn't appear on all farms or in all livestock operations. Many American farmers have found that consumers prefer meat, eggs and other products that are produced without antibiotics, including those that are sold as organic or locally raised. Note, too, that the problem doesn't stem from giving antibiotics to animals that truly have bacterial illnesses. Instead, it's the misuse of the drugs that's to blame.
The link between drug-resistant bacteria and the misuse of the drugs by large-scale industrial livestock operations has been reported by the U.S. Centers for Disease Control, the National Academies of Science and the World Health Organization. Such research convinced the European Union to ban the practice.
U.S. Sen. Sherrod Brown is sponsoring legislation that would phase out the misuse of antibiotics used in factory farms. Although the bill has support from the Ohio Association of Boards of Health, the Ohio Nurses Association and the Ohio Public Health Association, it still has languished in committee for years.
Meanwhile, the effectiveness of lifesaving drugs has continued to wane.
This summer, Congress made modest progress by requiring pharmaceutical companies to report the quantities and intended use of antibiotics they sell for industrial farm animal production. Congress did not, however, require the companies to report how the drugs are actually used. So while the public will be getting some information from the drug makers, other critical data still will be missing.
As Winslow, Brady and Manning know, the best defense is a good offense. That means directly tackling the problem of antibiotic misuse where it's found: on the factory farms.
Shelley Hearne holds a doctorate degree in public health and is the managing director of Health and Human Services Policy at the Pew Charitable Trusts. Tom Bullock lives in Lakewood and is the Pew Environment Group's Ohio representative.