MRSA common among student athletes

Methicillin-resistant Staphylococcus aureus colonization was a widespread occurrence among collegiate athletes during peaks in their respective athletic seasons, according to recent study data.

Researchers from the Vanderbilt University Medical Center and Vanderbilt Children’s Hospital in Nashville, Tenn., performed a prospective observational cohort study on the prevalence and implications of MRSA colonization among the school’s men’s football and women’s lacrosse teams during highs (regular seasons) and lows (pre- and postseasons) of athletic activity.

The researchers gathered monthly nasal samples from the athletes and collected information on risk factors for developing infection via questionnaire. These surveys included questions on team position; history of skin or soft tissue infections; history of staphylococcal infections; recent antibiotic use; recent hospitalization or surgery; history of chronic skin disorders; and exposure to individuals with confirmed MRSA disease. Development of apparent skin or soft tissue infections among the athletes was also assessed.

One hundred football players, who represented 98% of the team, participated in the study during eight sampling periods, according to the researchers, with S. aureus nasal colonization rates ranging from 4% during the summer off-season to 19% at the close of the regular football season. This trend was also observed when comparing the overall levels of colonization during the regular season (16.5%) with those during spring training (8.4%; P=.003), the off-season (4.4%; P=.004) or postseason (7.7%; P=.04).

The researchers reported that 54% of the football players had at least one S. aureus-positive culture during the study, with 37% having at least one MRSA-positive culture. Data indicated that race, college year, football position, history of antibiotic use within 6 months or hospitalization within 1 year had no effect on nasal colonization or the presence of MRSA.

Similar results were seen among the women’s lacrosse team, the researchers noted. The study sample was composed of the entire team of 26 players. Because there were two lacrosse seasons, spring and fall, the researchers collected nasal specimens beginning in March and August. Players did not remain on campus during the summer, however, so data for only six sampling periods were available.

In this group, S. aureus colonization rates ranged from a low of 28% to a peak of 39%. The researchers reported that frequency of colonization was lowest during the winter postseason and highest during the regular fall season. MRSA nasal colonization ranged from 11% to 23% and was highest during the regular spring and fall seasons. Other factors, such as race, college year, position, history of antibiotic use or history of hospitalization did not affect the results.

Skin and soft tissue infections were uncommon among both teams, the researchers said, and occurred in only four football players and one lacrosse player. These infections included pustular lesions and the development of carbuncles with Proteus mirabilis. Additionally, no dominant strain of MRSA emerged among the samples, they noted.

“The potential exists for other unknown factors, including the molecular characteristics of carriage strains, to govern the development of a [MRSA] outbreak,” the researchers wrote. “Additional longitudinal studies of staphylococcal colonization and disease are critically needed to determine the most effective means of primary prevention of this potentially devastating pathogen.”

Creech CB. Arch Pediatr Adolesc Med. 2010;164:615-620.

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