Athletes in contact sports more likely to carry MRSA

PHILADELPHIA — Contact sport athletes were more likely to carry methicillin-resistant Staphylococcus aureus compared with non-contact sport athletes, according to data presented at IDWeek 2014.

Perspective from Paul G. Auwaerter

“Our findings indicated that those in contact sports are at higher risk for carrying this bacteria MRSA and potentially to gain infections,” Natalia Jimenez-Truque, PhD, MSCI, of the Vanderbilt University Medical Center, said during a press conference. “What we should do to prevent it is stress good hygiene in these athletes, which is to tell them to wash hands regularly, shower after every game and practice, wash equipment frequently … not share personal items, and if they have a wound or a cut, cover it appropriately.”

Natalia Jimenez-Truque

Researchers examined monthly nasal and oropharyngeal swabs obtained from college varsity athletes (n=377) of both contact (n=224) and non-contact (n=153) sports. Primary outcomes were the presence of methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA), with secondary outcome being time to colonization with S. aureus.

Researchers found that contact sport athletes had higher odds of being colonized with MRSA (OR=2.36; 95% CI, 1.13-4.93) than non-contact athletes, and acquired S. aureus more quickly (HR=1.61; 95% CI, 1.02-2.55). More contact sport athletes also carried S. aureus for longer periods, both as an intermittent carrier (OR=3.60; 95% CI, 2.02-6.40) and as a persistent carrier (OR=2.36; 95% CI, 1.13-4.93).

Jimenez-Truque said that football players specifically had higher rates of MRSA colonization than other contact sport athletes, but that this could be a result of that sport making up the largest portion of the sample.

C. Buddy Creech

“The first step, which is something we can all do right now that doesn’t require additional high-tech stuff or additional research, is really focusing on some of those very basic infection prevention things that we know already work,” C. Buddy Creech, MD, MPH, of the Vanderbilt University Medical Center, and member of the Infectious Diseases in Children Editorial Board, said during the press conference. – by David Muoio

For more information:

Jimenez-Truque N. Abstract 298. Presented at: IDWeek 2014 ; Oct. 8-12, 2014; Philadelphia.

Disclosure: One researcher reported serving as a grant investigator and scientific advisor for Novartis.

Perspective

Paul G. Auwaerter

Though physical injuries deservedly garner more attention and concern among athletes, staphylococcal infections have occasionally gotten press for interfering in professional sports, such as the outbreak of MRSA infections among the 2003 St. Louis Rams football players (Kazakova SV. N Engl J Med. 2005;352:468-475) or slugger Sammy Sosa’s infection that kept him out of Major League Baseball for more than a month.

As a parent of a college football player, I read this study with interest. This Vanderbilt series confirms the previously known higher rates of staphylococcal nasal colonization among athletes, especially those participating in team contact sports such as football, soccer, lacrosse and basketball.

Although actual infections were not described, this work does document that about two-thirds of contact-sport players were eventually colonized within 1 year, 60% of whom had persistent positive swabs. It’s surprising then that more trouble isn’t seen given the high rates of staphylococcal colonization, but this may be attenuated by lack of comorbidities in young athletes as well as adequate routine hygiene. If wider-spread outbreaks occur among contact sport teams, these data do suggest that, beyond the locker-room environmental cleaning, mass decolonization efforts among team members may have an impact.

Paul G. Auwaerter

Professor of Medicine at Johns Hopkins University School of Medicine

Clinical director of the infectious diseases division

Disclosures: Auwaerter has served as a consultant for Adamas Pharmaceuticals, LifeCell, Schering-Plough and Wyeth.