Methicillin-Resistant Staphylococcus aureus (MRSA)
Outbreaks of skin infections caused by antibiotic-resistant bacteria have been increasingly reported in sports teams including football, basketball, wrestling, volleyball and rowing teams. The athletic department, coach, trainers, and athletes share responsibility and must work together to ensure prevention and control of these skin infections.
Staphylococcus aureus, often referred to simply as "staph," are bacteria commonly carried on the skin or in the nose of healthy people. Approximately 25% to 30% of the population is colonized (when bacteria are present, but not causing an infection) in the nose with staph bacteria. It can also be carried in the armpit, groin, or genital area. Staph bacteria are one of the most common causes of skin infections in the United States. Most of these skin infections are minor (such as pimples and boils) and can be treated without antibiotics. However, staph also can cause serious infections such as pneumonia, bloodstream infections, and joint infections. Most infections occur through direct physical contact of the staphylococci with a break in the skin (cut or scrape). The staph can be spread by the infected person to someone else or to an object. Inanimate objects, such as clothing, bed linens, sports equipment, personal items (soap or wash cloths) or furniture, may be a source of infection if they become soiled with wound drainage and a non-infected person comes into contact with them. If there is no break in the skin, contact with infected persons or contaminated objects may result in colonization. Susceptibility to infection depends on factors such as immunity and general state of health. In the past, these staph infections typically have been easy to treat with an inexpensive, short course, usually well-tolerated antibiotics. Now in most communities in the U.S., over half of the staph causing skin infections are resistant to commonly used antibiotics, and the infections often return in spite of apparently successful initial treatment.
Methicillin-resistant Staphylococcus aureus (MRSA)
MRSA is Staphylococcus aureus that is resistant to the penicillin's, including dicloxacillin or other methicillin-related antibiotics. These bacteria are also resistant to the cephalosporins, such as Keflex®. Originally MRSA was confined to hospitals and long-term care facilities; taking antibiotics was a risk factor for infection with MRSA. Many of these hospital-associated MRSA infections caused very serious complications and were resistant to all oral antibiotics. More recently a newer, more virulent strain of MRSA has emerged in the community that causes boils, abscesses, and other soft tissue infections that is not linked to previous antibiotic use. It is called community-associated MRSA. The frequency of infections with community-associated MRSA appears to be higher that those caused by staph in the past, particularly in athletic teams. The reasons for this increase are not known, but it is clear that the community-associated MRSA strains did not originate from the strains of MRSA that cause infections in hospitals and other healthcare facilities.
On February 14, 2008, severe cases of Staphylococcus aureus infections, including methicillin-resistant Staphylococcus aureus (MRSA), was added to the list of diseases reported by healthcare providers to local health departments in the state.