Preventing MRSA Infections in Sports: Effective Strategies and Approaches
DOI:
https://doi.org/10.12775/QS.2024.31.55764Keywords
Community-acquired methicillin-resistant Staphylococcus aureus, MRSA, colonization, athletes, Staphylococcus aureusAbstract
Introduction: Infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are a growing concern, particularly among asymptomatic individuals. CA-MRSA can lead to various conditions such as skin infections, septic arthritis, pyomyositis, endocarditis, and pubic osteomyelitis, with athletes being especially vulnerable due to shared equipment, close contact, and skin trauma. Prolonged colonization of the anterior nares and persistence on shared surfaces contribute to its spread.
Purpose of work: This study aims to review MRSA prevalence in sports and provide effective strategies for prevention and management.The purpose of this paper is to evaluate MRSA prevalence in sports and provide effective strategies for prevention and management.
Materials and methods: A comprehensive analysis of research papers available on PubMed, Google Scholar and Scopus was undertaken using the search terms encompassing the following keywords: Community- acquired MRSA / MRSA and Sport / MRSA and athletes / MRSA Prevention Strategies in Sports / MRSA Infection Risks in Athletes / MRSA Colonization and Sports Participation.
Results: A meta-analysis found that about 6% of asymptomatic athletes are colonized with MRSA, though rates vary by sport and country. Decolonization methods may reduce infection risk, but their effects are often temporary. This study examines MRSA colonization and infections in athletes, stressing the importance of preventive measures.
References
Karanika S, Kinamon T, Grigoras C, Mylonakis E. Colonization with methicillin-resistant Staphylococcus aureus and risk for infection among asymptomatic athletes: a systematic review and meta-analysis. Clin Infect Dis. 2016;63(2):195-204. doi:10.1093/cid/ciw240
David MZ, Daum RS. Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev. 2010;23(3):616-687. doi:10.1128/CMR.00081-09
Brancaccio M, Mennitti C, Laneri S, et al. Methicillin-Resistant Staphylococcus aureus: Risk for General Infection and Endocarditis Among Athletes. Antibiotics (Basel). 2020;9(6):332. Published 2020 Jun 18. doi:10.3390/antibiotics9060332
Many PS. Preventing community-associated methicillin-resistant Staphylococcus aureus among student athletes. J Sch Nurs. 2008;24(6):370-378. doi:10.1177/1059840508326448
Creech CB, Saye E, McKenna BD, et al. One-year surveillance of methicillin-resistant Staphylococcus aureus nasal colonization and skin and soft tissue infections in collegiate athletes. Arch Pediatr Adolesc Med. 2010;164(7):615-620. doi:10.1001/archpediatrics.2010.93
Ellis MW, Hospenthal DR, Dooley DP, Gray PJ, Murray CK. Natural history of community-acquired methicillin-resistant Staphylococcus aureus colonization and infection in soldiers. Clin Infect Dis. 2004;39(7):971-979. doi:10.1086/423965
Haghverdian B., Patel N., Wang L., Cotter J.C. The Sports Ball as a Fomite for Transmission of Staphylococcus aureus. J. Environ. Health. 2018;80:8–13.
Maucotel AL, Kolenda C, Laurent F, Tristan A. Staphylococcus aureus: No ticket for the Paris 2024 Olympic Games!. Infect Dis Now. 2024;54(4S):104882. doi:10.1016/j.idnow.2024.104882
Jevons, M. “Celbenin”- resistant staphylococci. BMJ 1, 124–125 (1961).
Dzintars, K. in Kucers’ The Use of Antibiotics (eds Grayson, M. et al.) 136–142 (CRC Press, 2018).
Lakhundi S, Zhang K. Methicillin-Resistant Staphylococcus aureus: Molecular Characterization, Evolution, and Epidemiology. Clin Microbiol Rev. 2018;31(4):e00020-18. Published 2018 Sep 12. doi:10.1128/CMR.00020-18
Moriya M, Tsurukiri J, Nakaminami H, et al. A risk as an infection route: Nasal colonization of methicillin-resistant Staphylococcus aureus USA300 clone among contact sport athletes in Japan. J Infect Chemother. 2020;26(8):862-864. doi:10.1016/j.jiac.2020.04.027
Takadama S., H. Nakaminami, A. Sato, M. Shoshi, T. Fujii, N. Noguchi Dissemination of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus USA300 clone in multiple hospitals in Tokyo, JapanClin Microbiol Infect, 24 (2018) 1211 e1-11 e7
Karanika S., T. Kinamon, C. Grigoras, E. Mylonakis Colonization with methicillin-resistant Staphylococcus aureus and risk for infection among asymptomatic athletes: a systematic review and metaanalysis Clin Infect Dis, 63 (2016), pp. 195-204
Kazakova SV, Hageman JC, Matava M, et al. A clone of methicillin-resistant Staphylococcus aureus among professional football players. N Engl J Med. 2005;352(5):468-475. doi:10.1056/NEJMoa042859
Begier EM, Frenette K, Barrett NL, et al. A high-morbidity outbreak of methicillin-resistant Staphylococcus aureus among players on a college football team, facilitated by cosmetic body shaving and turf burns. Clin Infect Dis. 2004;39(10):1446-1453. doi:10.1086/425313
Nguyen DM, Mascola L, Brancoft E. Recurring methicillin-resistant Staphylococcus aureus infections in a football team. Emerg Infect Dis. 2005;11(4):526-532. doi:10.3201/eid1104.041094
Centers for Disease Control and Prevention (CDC). Methicillin-resistant Staphylococcus aureus infections among competitive sports participants -Colorado, Indiana, Pennsylvania, and Los Angeles County, 2000–2003. MMWR Morb. Mortal. Wkly. Rep. 2003, 2, 793–795.
Dalman M, Bhatta S, Nagajothi N, et al. Characterizing the molecular epidemiology of Staphylococcus aureus across and within fitness facility types. BMC Infect Dis. 2019;19(1):69. Published 2019 Jan 18. doi:10.1186/s12879-019-3699-7
Mascaro V, Capano MS, Iona T, Nobile CGA, Ammendolia A, Pavia M. Prevalence of Staphylococcus aureus carriage and pattern of antibiotic resistance, including methicillin resistance, among contact sport athletes in Italy. Infect Drug Resist. 2019;12:1161-1170. Published 2019 May 7. doi:10.2147/IDR.S195749
Shaban RZ, Li C, O'Sullivan MVN, et al. Outbreak of community-acquired Staphylococcus aureus skin infections in an Australian professional football team. J Sci Med Sport. 2021;24(6):520-525. doi:10.1016/j.jsams.2020.11.006
Zervou FN, Zacharioudakis IM, Ziakas PD, Rich JD, Mylonakis E. Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus colonization in HIV infection: a meta-analysis. Clin Infect Dis. 2014;59(9):1302-1311. doi:10.1093/cid/ciu559
Zacharioudakis IM, Zervou FN, Ziakas PD, Mylonakis E. Meta-analysis of methicillin-resistant Staphylococcus aureus colonization and risk of infection in dialysis patients. J Am Soc Nephrol. 2014;25(9):2131-2141. doi:10.1681/ASN.2013091028
Graham PL 3rd, Lin SX, Larson EL. A U.S. population-based survey of Staphylococcus aureus colonization. Ann Intern Med. 2006;144(5):318-325. doi:10.7326/0003-4819-144-5-200603070-00006
Salgado CD, Farr BM, Calfee DP. Community-acquired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factors. Clin Infect Dis. 2003;36(2):131-139. doi:10.1086/345436
Couvé-Deacon E, Postil D, Barraud O, et al. Staphylococcus Aureus Carriage in French Athletes at Risk of CA-MRSA Infection: a Prospective, Cross-sectional Study. Sports Med Open. 2017;3(1):28. doi:10.1186/s40798-017-0094-z
den Heijer CDJ, van Bijnen EME, Paget WJ, et al. Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant S. aureus, in nine European countries: a cross-sectional study. Lancet Infect Dis. 2013;13(5):409-415. doi:10.1016/S1473-3099(13)70036-7
Creutz I, Busche T, Layer F, Bednarz H, Kalinowski J, Niehaus K. Evaluation of virulence potential of methicillin-sensitive and methicillin-resistant Staphylococcus aureus isolates from a German refugee cohort. Travel Med Infect Dis. 2022;45:102204. doi:10.1016/j.tmaid.2021.102204.
Jiménez-Truque N, Saye EJ, Soper N, et al. Association Between Contact Sports and Colonization with Staphylococcus aureus in a Prospective Cohort of Collegiate Athletes. Sports Med. 2017;47(5):1011-1019. doi:10.1007/s40279-016-0618-6
Ožegić O, Bedenić B, Sternak SL, Sviben M, Talapko J, Pažur I, Škrlec I, Segedi I, Meštrović T. Antimicrobial Resistance and Sports: The Scope of the Problem, Implications for Athletes’ Health and Avenues for Collaborative Public Health Action. Antibiotics. 2024; 13(3):232. doi:10.3390/antibiotics13030232
Lear A, McCord G, Peiffer J, Watkins RR, Parikh A, Warrington S. Incidence of Staphylococcus aureus nasal colonization and soft tissue infection among high school football players. J Am Board Fam Med. 2011;24(4):429-435. doi:10.3122/jabfm.2011.04.100286
Oller AR, Province L, Curless B. Staphylococcus aureus recovery from environmental and human locations in 2 collegiate athletic teams. J Athl Train. 2010;45(3):222-229. doi:10.4085/1062-6050-45.3.222
Garza D, Sungar G, Johnston T, Rolston B, Ferguson JD, Matheson GO. Ineffectiveness of surveillance to control community-acquired methicillin-resistant Staphylococcus aureus in a professional football team. Clin J Sport Med. 2009;19(6):498-501. doi:10.1097/JSM.0b013e3181bd09e0
Romano R, Lu D, Holtom P. Outbreak of community-acquired methicillin-resistant Staphylococcus aureus skin infections among a collegiate football team. J Athl Train. 2006;41(2):141-145.
Rihn JA, Posfay-Barbe K, Harner CD, et al. Community-acquired methicillin-resistant Staphylococcus aureus outbreak in a local high school football team unsuccessful interventions. Pediatr Infect Dis J. 2005;24(9):841-843. doi:10.1097/01.inf.0000177287.11971.d4
Archibald LK, Shapiro J, Pass A, Rand K, Southwick F. Methicillin-resistant Staphylococcus aureus infection in a college football team: risk factors outside the locker room and playing field. Infect Control Hosp Epidemiol. 2008;29(5):450-453. doi:10.1086/587971
Sutton SS, Stacy JJ, Mensch J, Torres-McGehee T, Bennett CL. Tackling community-acquired methicillin-resistant Staphylococcus aureus in collegiate football players following implementation of an anti-MRSA programme. Br J Sports Med. 2014;48(4):284-285. doi:10.1136/bjsports-2012-091689
Huijsdens XW, van Lier AM, van Kregten E, et al. Methicillin-resistant Staphylococcus aureus in Dutch soccer team. Emerg Infect Dis. 2006;12(10):1584-1586. doi:10.3201/eid1210.060387
Stevens MP, Bearman G, Rosato A, Edmond M. Community-acquired methicillin resistant Staphylococcus aureus in a women's collegiate basketball team. South Med J. 2008;101(10):1067-1068. doi:10.1097/SMJ.0b013e318186b81c
Couvé-Deacon E, Tristan A, Pestourie N, et al. Outbreak of Panton-Valentine Leukocidin-Associated Methicillin-Susceptible Staphylococcus aureus Infection in a Rugby Team, France, 2010-2011. Emerg Infect Dis. 2016;22(1):96-99. doi:10.3201/eid2201.150597
Stacey AR, Endersby KE, Chan PC, Marples RR. An outbreak of methicillin resistant Staphylococcus aureus infection in a rugby football team. Br J Sports Med. 1998;32(2):153-154. doi:10.1136/bjsm.32.2.153
Rackham DM, Ray SM, Franks AS, Bielak KM, Pinn TM. Community-associated methicillin-resistant Staphylococcus aureus nasal carriage in a college student athlete population. Clin J Sport Med. 2010;20(3):185-188. doi:10.1097/JSM.0b013e3181dba80d
Wang HK, Huang CY, Chen CJ, Huang YC. Nasal Staphylococcus aureus and methicillin-resistant Staphylococcus aureus carriage among college student athletes in northern Taiwan. J Microbiol Immunol Infect. 2017;50(4):537-540. doi:10.1016/j.jmii.2016.11.005
Braun T, Kahanov L, Dannelly K, Lauber C. CA-MRSA Infection Incidence and Care in High School and Intercollegiate Athletics. Med Sci Sports Exerc. 2016;48(8):1530-1538. doi:10.1249/MSS.0000000000000940
Zaborova VA, Arzumanin VG, Gurevich KG, et al. Species variety of staphylococcal microflora of the skin in athletes engaged in water sports. Bull Exp Biol Med. 2011;151(6):738-740. doi:10.1007/s10517-011-1429-2
Safdar N, Bradley EA. The risk of infection after nasal colonization with Staphylococcus aureus. Am J Med. 2008;121(4):310-315. doi:10.1016/j.amjmed.2007.07.034
Liu C, Bayer A, Cosgrove SE, et al. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children [published correction appears in Clin Infect Dis. 2011 Aug 1;53(3):319]. Clin Infect Dis. 2011;52(3):e18-e55. doi:10.1093/cid/ciq146
Rodriguez-Merchan EC. Screening and decolonization of MRSA among joint arthroplasty patients: efficacy, cost-effectiveness, and durability. J Acute Dis. 2014;3:218-220
Laupland KB, Conly JM. Treatment of Staphylococcus aureus colonization and prophylaxis for infection with topical intranasal mupirocin: an evidence-based review. Clin Infect Dis. 2003;37(7):933-938. doi:10.1086/377735
Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus (MRSA) in athletes. Accessed September 18, 2024. Available from: https://www.cdc.gov/mrsa/prevention/athletes.html
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Karolina Pawłuszkiewicz, Natalia Kucharczyk, Emilia Kucharczyk
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 112
Number of citations: 0
