Methicillin-resistant staphylococcus aureus infections among competitive sports participants—Colorado, Indiana, Pennsylvania, and Los Angeles County, 2000-2003

Morbidity and Mortality Weekly Report, August 22, 2003 by N Gantz, H Harmon, J Handy, K Gershman, J Butwin, L Mascola, A Weltman, R Groner, A Cronquist, M Kainer, N Lee

Previous outbreaks of staphylococcal skin infection have been reported among wrestlers and rugby and football players (4-7). In these outbreaks, risk factors have included skin trauma (4,7) and contact with lesions of other players (7). The findings in this report, particularly the cluster of MRSA infections among participants in a sport with little skin-to-skin contact, suggest that sharing equipment or personal items also might facilitate MRSA transmission. Although none of the fencers reported sharing equipment nr clothing items, their use of shared sensor wires was not assessed specifically.

Maintaining good hygiene and avoiding contact with drainage flora skin lesions of other players are the best methods for preventing spread of staphylococcal skin infections. Guidelines for preventing skin infections among sports team participants should be followed (6-10). All persons associated with competitive sports teams, including players, coaches, teachers, parents, and administrators, can help prevent sports-related skin infections and should be aware of prevention measures (Box). Sports team administrators should be encouraged to provide facilities and equipment necessary to promote good hygiene, such as clean facilities and adequate supplies of soap and towels. Coaches and parents should encourage good hygiene among players, and they should be taught to administer proper first aid, practice appropriate hand hygiene, and implement a system to ensure adequate would care and to cover skin lesions appropriately before play. Players should be encouraged to practice good hygiene, avoid sharing towels or other personal items, and inform coaches about active skin infections. Additional information about MRSA ls available at http://www.cdc.gov/ncidod/hip/aresist/mrsa.htm, or by telephone, 800-893-0485.

BOX. Measures for preventing staphylococcal skin infections
among sports participants

* Cover all wounds. If a wound cannot be covered
  adequately, consider excluding players with potentially
  infectious skin lesions from practice or competitions
  until the lesions are healed or can be covered adequately.

* Encourage good hygiene, including showering and washing
  with soap after all practices and competitions.

* Ensure availability of adequate soap and hot water.

* Discourage sharing of towels and personal items (e.g.,
  clothing or equipment).

* Establish routine cleaning schedules for shared equipment.

* Train athletes and coaches in first aid for wounds and
  recognition of wounds that are potentially infected.

* Encourage athletes to report skin lesions to coaches and
  encourage coaches to assess athletes regularly for skin
  lesions.

References

(1.) Shahin R, Johnson I, Jamieson F, et al. Methicillin-resistant staphylococcus aureus carriage in a childcare center following a case of disease. Arch Pediatr Adolesc Med 1999;153:864 8.

(2.) CDC. Outbreak of community-associated methicillin-resistant Staphylococcus aureus skin infections--Los Angeles County, California, 2002 2003. MMWR 2003;52:88.