Methicillin-resistant Staphylococcus aureus (MRSA, pronounced mersa) infection isn’t exactly a household name. But it’s becoming better known as it affects people of all ages, not just older adults in the hospital or a nursing home. It’s even been reported in healthy, young adult athletes.
MRSA is a bacterium responsible for difficult-to-treat staph infections in humans. It’s resistant to a large group of antibiotics including penicillin and cephalosporin drugs. That makes it a dangerous infection that can spread, even causing unexpected deaths in children and young adults. When it’s acquired outside the hospital or institutional setting, it’s referred to as community acquired MRSA or CA-MRSA.
CA-MRSA was first reported in a group of children back in the 1980s. Then the 2003 death of a college football player brought the disease to everyone’s attention. CA-MRSA starts as a simple skin infection. If it’s found early enough, it can be treated successfully with antibiotics. But if it’s undetected or ignored, the infection can become much more serious. Osteomyelitis (bone infection), necrotizing pneumonia (death of lung tissue), and sepsis (blood infection) can develop as a result of MRSA.
Risk factors for CA-MRSA include the overuse of antibiotics, crowded living conditions (including locker rooms), and open skin lesions. Locker rooms aren’t the only crowded areas where people are at risk for CA-MRSA. Prison inmates, soldiers and other military workers, children in day care centers, and any athlete participating in competitive sports are at increased risk for this condition.
CA-MRSA has become so common now that hospital personnel estimate it is present in 50 to 80 per cent of all skin infections seen in the emergency department. That means education and prevention are key factors in reducing the risk of this potentially deadly problem.
Hospital and emergency department staff must evaluate all patients for skin or soft tissue lesions that could be at risk for MRSA. Likewise, athletic trainers, coaches, team physicians, and even the players must know what to look for and how to prevent it.
A few simple steps can be taken in the locker room to reduce the spread of CA-MRSA. Hand washing and the use of hand gels are a must. Special anti-MRSA soaps have been developed. Players should not share (or even ask others to share with them) items such as towels, water bottles, shavers, or other personal items.
There’s no place in this environment for a quick shower. Players should soap down, wash, rinse, and towel dry after each workout. The showers, exercise equipment, and other areas athletes come in contact with must be disinfected on a regular basis. Those in charge of laundry should be instructed to use hot water and a hot dryer when washing the uniforms. There is a risk that the clothes will shrink, but this will help kill bacteria.
Anyone with a skin infection (especially one that is open, oozing, or draining) must have proper wound care and coverage of the site. Any lesions that can’t be covered will put the athlete on the bench until healing occurs.
The team physician must work with the coaching staff and athletes to ensure that antibiotics (when prescribed) are taken in the proper way. The appropriate antibiotic must be chosen. The correct dosage must be prescribed. And the athlete must take the medication as instructed. Many people stop taking the drug as soon as the most recognizable symptoms are gone. This type of drug-taking is one of the main reasons bacteria have become resistant to certain antibiotics.
Anyone who is planning to have surgery is at increased risk of MRSA. Scientists are actively looking for a way to kill off the bacteria before doing surgery. This process is referred to as decolonization. The method involves a decolonization agent. Such a chemical would reduce (or eliminate) the number of bacteria on the skin and keep it from growing again. Studies are ongoing trying to find the perfect agent to do both.