MRSA outbreak

U.S.News & World Report ^ | 11/12/04 | Helen Fields

[neverdem]

Infection spreads among Connecticut college football team

Methicillin-resistant Staphylococcus aureus infections were once a worry only for people in hospitals. But in recent years, there have been more and more reports of MRSA being transmitted in the community. S. aureus, or staph, is a common bacterium, and many healthy people carry it around without ever knowing about it. It can cause skin infections, though, and MRSA is resistant to many of the antibiotics commonly used to treat staph infections. Researchers report an MRSA outbreak in a Connecticut college football team in the journal Clinical Infectious Diseases.

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What the researchers wanted to know: How did MRSA spread among these college football players?

What they did: After several MRSA skin infections were reported to the Connecticut Department of Health among the players on a college football team, the university's health center took samples from the noses of the players, trainers, and coaches to find out if anyone was carrying MRSA there (no one was, although many had normal staph bacteria). They also took groin and armpit samples from patients with infections. The players, trainers, and coaches were interviewed in person to find out about skin injuries, whether they shared towels, and other ways that the bacteria could have spread. The researchers compared the 10 players who had MRSA skin infections with the 90 who didn't.

What they found: Players who'd had turf burns were seven times more likely to get an MRSA infection. Players who shaved part of their body were six times more likely to develop MRSA infections; the risk was even higher for those who shaved their genitals or groin. Cornerbacks and wide receivers were the most likely to be infected; the researchers say the bacteria were probably spread by frequent body contact between those players in drills and scrimmages. Then the bacteria would have been ready to infect the skin after any turf burns or razor nicks. The players who shaved were doing it for looks, not for the game.

What the study means to you: An MRSA infection usually isn't a serious problem for an otherwise healthy person. But an unhealthy person who contracts an MRSA infection and is unable to fight it off could be in danger, because regular antibiotics won't work on it. That's why public health officials get excited about MRSA outbreaks—no one wants these bacteria to become common. In this case, two of the men were hospitalized with cellulitis, an infection of the connective tissue under the skin; one had to get IV vancomycin for three weeks, and the other for two weeks.

Caveats: The researchers say using the whirlpools in the locker room might also have increased infection risk, because they weren't properly disinfected. Unfortunately, they didn't have enough detail about players' use of the whirlpools to figure out just how that related to their risk.

Find out more: Information about methicillin-resistant Staphylococcus aureus from the Centers for Disease Control and Prevention.

Read the article: Begier, E.M., et al. "A High-Morbidity Outbreak of Methicillin-Resistant Staphylococcus aureus Among Players on a College Football Team, Facilitated by Cosmetic Body Shaving and Turf Burns." Clinical Infectious Diseases. Nov. 15, 2004, Vol. 39, pp. 1446–1453.

Abstract online: http://www.journals.uchicago.edu

[neverdem]

Clinical Infectious Diseases    2004;39:1446-1453
© 2004 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2004/3910-0008$15.00

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MAJOR ARTICLE

A High-Morbidity Outbreak of Methicillin-Resistant Staphylococcus aureus among Players on a College Football Team, Facilitated by Cosmetic Body Shaving and Turf Burns

Elizabeth M. Begier,^1,4 Kasia Frenette,¹ Nancy L. Barrett,^1,2 Pat Mshar,¹ Susan Petit,^1,2 Dave J. Boxrud,⁵ Kellie Watkins-Colwell,³ Sheila Wheeler,³ Elizabeth A. Cebelinski,⁵ Anita Glennen,⁵ Dao Nguyen,^4,6 James L. Hadler,¹ and the Connecticut Bioterrorism Field Epidemiology Response Team^a

¹Infectious Diseases Division and ²Connecticut Active Bacterial Core Surveillance Project, Connecticut Department of Public Health, Hartford, and ³Student Health Services of Sacred Heart University, Fairfield, Connecticut; ⁴Epidemic Intelligence Service Program, Centers for Disease Control and Prevention, Atlanta, Georgia; ⁵Division of Public Health Laboratories, Minnesota Department of Public Health, Minneapolis, Minnesota; and ⁶Los Angeles County Department of Health Services, Los Angeles, California

     Background.     Athletics-associated methicillin-resistant Staphylococcus aureus (MRSA) infections have become a high-profile national problem with substantial morbidity.
     Methods.     To investigate an MRSA outbreak involving a college football team, we conducted a retrospective cohort study of all 100 players. A case was defined as MRSA cellulitis or skin abscess diagnosed during the period of 6 August (the start of football camp) through 1 October 2003.

     Results.     We identified 10 case patients (2 of whom were hospitalized). The 6 available wound isolates had indistinguishable pulsed-field gel electrophoresis patterns (MRSA strain USA300) and carried the Panton-Valentine leukocidin toxin gene, as determined by polymerase chain reaction. On univariate analysis, infection was associated (P < .05) with player position (relative risk [RR], 17.5 and 11.7 for cornerbacks and wide receivers, respectively), abrasions from artificial grass (i.e., "turf burns"; RR, 7.2), and body shaving (RR, 6.1). Cornerbacks and wide receivers were a subpopulation with frequent direct person-to-person contact with each other during scrimmage play and drills. Three of 4 players with infection at a covered site (hip or thigh) had shaved the affected area, and these infections were also associated with sharing the whirlpool 2 times per week (RR, 12.2; 95% confidence interval, 1.4109.2). Whirlpool water was disinfected with dilute povidone-iodine only and remained unchanged between uses.

     Conclusions.     MRSA was likely spread predominantly during practice play, with skin breaks facilitating infection. Measures to minimize skin breaks among athletes should be considered, including prevention of turf burns and education regarding the risks of cosmetic body shaving. MRSA-contaminated pool water may have contributed to infections at covered sites, but small numbers limit the strength of this conclusion. Nevertheless, appropriate whirlpool disinfection methods should be promoted among athletic trainers.

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     Received 12 April 2004; accepted 29 June 2004; electronically published 26 October 2004.
     ^a Members of the study group are listed at the end of the text.

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[Perdogg]

Players who shaved part of their body were six times more likely to develop MRSA infections; the risk was even higher for those who shaved their genitals or groin. WTF?

[neverdem]

WTF! Exactly and half the reason I posted this. Kids are pretty weird these days. The other association that caught my eye was the turf burns. That's new to me.

[Perdogg]

My dad commented when MTV showed clips from Spring break and the guys had shaved their chest hair off. To each his own, but if the guys shave down there.....they are clothed when they play football, right????

[elizabetty]

They shave their groin and then the shaved area comes in contact with the turf? Do they have pants-free scrimmages?

[Perdogg]

I don't want to thik about that one. Especially the center-QB exchange.

[Calvin Locke]

Kids are pretty weird these days.

Sounds like then-Congress critter Condit.

[neverdem]

FReepmail me if you want on or off my health and science ping list.

[MonaMars]

"The other association that caught my eye was the turf burns. That's new to me."

It's the microscopic breaks in the skin that turf burns cause. A nasty rug burn would probably create the same risk.

MRSA is one scary little bug.

[neverdem]

I took it as meaning artificial turf causing a friction burn. I'll reread it.

[tiki]

Any injury which basically cauterizes itself is apt to get infected. It's the scrapes and rug burn type wounds which should be treated immediately w/antiseptics because they seal the bacteria in the wound. Same w/puncture wounds. I hate to bleed but the blood carries out bacteria and then seals the wound. I'm not a doctor but I'm a mom and a grandmom and that's my experience.

[neverdem]

In the results section of the abstract it states, " abrasions from artificial grass (i.e., "turf burns"; RR, 7.2)."

The traction that you get from artificial turfs apparently causes unique problems as opposed to grass and dirt. I remember Joe Thiesman's leg popping like a pretzel when he was tackled on phony turf by Lawrence Taylor.

[neverdem]

I wouldn't call scraped and rub raw down to the dermis where your getting some bleeding from capillaries being cauterized.

[endthematrix]

Infections Among Competitive Sports Participants --- Colorado, Indiana, Pennsylvania, and Los Angeles County, 2000--2003
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5233a4.htm

[endthematrix]

It hurts more, may cause more superficial abrasion. But a grass burn is as susceptible to MSRA as the fake stuff.

[neverdem]

Thanks for the link.

[eddiebear]

Hate to be pedantic, but Joe snapped his leg at RFK, which was grass. Still, this is serious stuff. Glad my wife is pregnant with a girl.

[Canticle_of_Deborah]

Body shaving (everywhere) is popular with gays and body builders. The muscle definition is more striking without hair.

Don't ask me about groin shaving. I ain't going there. It may be a porn trend.

[neverdem]

Hate to be pedantic, but Joe snapped his leg at RFK, which was grass.

1985 REDSKINS 23 at GIANTS 21 ( VG to EX ) Remember when Lawrence Taylor broke Joe Theismann's leg...OUCH!!! what a historic game!!!! ONE YOU WILL NEVER FORGET!!!

Here's the URL:

http://www.geocities.com/jjsportsjunkie2000/gamelist_9_27_01.html

Giant Stadium has phony turf. I'm not a sports or football junkie, but I'm a Noo Yawker who happened to watch that game with my best friend who's a sports junkie. Any citations to prove me wrong are welcome. Put that URL in your browser. It's in chronological order almost halfway down the scroll.

[Dont Mention the War]

Don't ask me about groin shaving. I ain't going there. It may be a porn trend.

It is not "attractive" today for men to be hairy, anywhere. They could be doing it just to be more appealing to the female students they're trying to bag by the dozen.