Superbug

by Mary Helen Sprecher

Athletic programs promote health on a large scale: cardiovascular conditioning, muscle development, weight loss. Then, there is the competitive aspect—the school’s bragging rights and overall standings—plus, of course, the individual athlete’s chances of being noticed by college, corporate or professional scouts.

Maybe that combination of factors is why it is so easy to overlook an infection that seems minor. After all, something that resembles a spider bite or boil simply does not have the clout of a broken bone or a torn ACL, but doctors are cautioning coaches, athletic directors and trainers about Methicillin-resistant Staphylococcus Aureus (MRSA), a skin infection that starts small and can have serious consequences.

As its name suggests, MRSA is one of those so-called “superbugs,” a bacteria that is resistant to the broad-spectrum antibiotics typically used against such infections. For years, staph infections in general and MRSA in particular have been problems for healthcare professionals, as they posed a serious risk to patients, such as those in hospitals and hospices, whose immune systems were already compromised. However, the infection is now being reported among otherwise healthy patients, including athletes who come in contact with it while using locker rooms, saunas, and other facilities common to athletes.

Healthcare professionals have established a term for this type of infection Community-Associated MRSA (CA-MRSA). Because in its early stages, the infection can look minor (like a pimple, for example), athletes may overlook it and/or merely try self-treatment.

Not a good idea, say medical professionals. The infection can worsen and spread, leading to complications, including serious skin and soft tissue infections.

While cases of CA-MRSA have been reported among athletes, such as football players and wrestlers who have physical contact, the bacteria does not require that level of interaction to spread.

“Everyone has bacteria on their skin,” says Katie Passaretti, M.D., assistant professor of infectious diseases at Johns Hopkins Bayview Medical Center in Baltimore, MD. Staph bacteria, she notes, including those causing MRSA, can be present on otherwise healthy individuals. When that bacteria comes into contact with an open wound, it can enter the body and cause an infection.

The means of transmission can be completely innocent. For example, athletes in the locker room might use (even accidentally) another person’s towel or razor. They might use weight or strength training equipment right after another person who left perspiration on it. If the person who used the item previously was colonized with the bacteria (that is, the bacteria was present but not causing an infection), he or she might have left some of that bacteria on the towel, razor or equipment. If the next person has an open cut or sore and is not wearing a bandage over it, the bacteria can enter.

MRSA is a stubborn infection, but can be treated successfully by a doctor, particularly when seen promptly. More good news? It’s easy to prevent.

“People can do simple things like washing their hands frequently,” says Passaretti, who advocates educating athletes. Posting a notice in the locker room (see box on page 8) encourages precautions. Often athletes think that because they are healthy and do not practice high-risk behavior, they will not catch serious infections. However, CA-MRSA is a threat and can be passed from person to person without the infected individual ever knowing they have it.

Have plenty of hand sanitizer stations and take containers of sanitizer to practices and competitions. Teach athletes not to share uniforms, T-shirts, etc., and to see a doctor if a wound does not heal or gets worse. A number of skin infections and conditions can be passed from person to person, and only a medical professional should diagnose and treat them.

What is not necessary? Going overboard. You cannot create sterile conditions everywhere athletes go, although a variety of commercial products have proliferated, all claiming to prevent CA-MRSA.

“Everyone’s trying to cash in on MRSA,” notes Passaretti. “It gets a lot of focus, but really, staph infections have been for around a long time. It’s just now very much more in people’s eyes than it was.”

Note: For information on CA-MRSA, go to the National Institutes of Health’s educational website at http://health.nih.gov/ and type MRSA into the search box on the left side of the page.

Note: The American Sports Builders Association (ASBA) is a nonprofit association helping designers, builders, owners, operators and users understand quality sports facility construction. The ASBA sponsors informative meetings and publishes newsletters, books and technical construction guidelines for athletic facilities, including running tracks. Available at no charge is a listing of all publications offered by the Association, as well as the ASBA’s Membership Directory. Info: 866-501-ASBA (2722) or www.sportsbuilders.org.