Staph and MRSA Infections in Athletes

Staphylococcus aureus, also called staph, is an infection caused by bacteria that are commonly carried on the skin or in the nose of healthy people. Occasionally, normal staph can cause a minor skin infection such as a boil or pimples if the bacteria enter the skin through an open cut or sore. Typically, these infections are easily treated. In some instances, though, staph infections are more serious and need to be treated with antibiotics.

Overview

Some staph infections become increasingly resistant to antibiotics and are more difficult to treat. MRSA is a type of staph infection (methicillin-resistant Staphylococcus aureus) that is resistant to first-line antibiotics such as methicillin, amoxicillin, and penicillin. The original MRSA infections emerged in the 1960s and were associated with exposure in the healthcare setting, particularly in hospitals, and are referred to as hospital-acquired MRSA or "HA-MRSA." This type of MRSA infection is difficult to treat because it is not susceptible to stronger antibiotics such as clindamycin or Bactrim.

Community-Acquired MRSA

During the 1990s, MRSA infections started showing up in individuals outside of the healthcare community. These infections are called community-acquired MRSA or "CA-MRSA." It is the community acquired MRSA that has been recently making headline news.

Most staph infections occur in people with weak immune systems, but recently CA-MRSA infections have been showing up in healthy individuals.

Athletes, in particular, seem to be at higher risk of getting a CA-MRSA infection because of close physical contact with others during sports. Athletes are more likely to get CA-MRSA infections due to the way it typically spreads:

• Direct physical (skin-to-skin) contact with infected people
• Indirect contact by touching objects contaminated by the infected person's skin (towels, equipment, workout areas, sports equipment)

Symptoms

CA-MRSA and other staph skin infections begin with classic signs of infection: a red, swollen, and painful area on the skin that is often warm to the touch. As the infection becomes more serious, symptoms include:

• A skin abscess
• Drainage of pus or other fluids from the site
• Fever
• Chills
• Rash
• Fatigue
• Muscle aches
• Headache

Treatment

Because CA-MRSA is resistant to many common antibiotics, such as penicillin, amoxicillin, and cephalosporins, a stronger antibiotic, such as clindamycin or Bactrim, is prescribed. If the infection is more severe, other treatments may be provided in the hospital, including intravenous medication.

Prevention

Practicing good personal hygiene is the best way to avoid getting a CA-MRSA infection. Other recommendations for athletes include:

• Wash your hands thoroughly with soap and water
• Keep any wounds, cuts or abrasions clean and covered
• If a wound cannot be covered adequately, a player should not participate in contact sports
• Avoid contact with other athletes who have wounds
• Use pump soap dispensers with antibacterial soap and avoid bar soap
• Don't share towels, personal items, clothing or equipment
• Clean gym or sports equipment with disinfectant sprays before and after use

• Report any cuts or abrasions to the coach or team trainer and have them monitored as they help
• Pay attention to signs and symptoms of infection as listed above and see a doctor if healing is delayed

Sources:

CDC. Methicillin-Resistant Staphylococcus aureus infections among competitive sports participants, Colorado, Indiana, Pennsylvania, and Los Angeles County, 2000-2003. MMWR 2003; 52(33); 793-795.

Centers for Disease Control and Prevention. CA-MRSA Information for Clinicians.

Centers for Disease Control and Prevention. Healthcare-associated MRSA (HA-MRSA).