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MRSA: Implications in Sports Medicine Staphylococcus aureus , often referred to as “staph”, are bacteria commonly carried on the skin or in the nose of healthy people Staphylococcus Aureus Occasionally, staph can cause an infection

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mrsa implications in sports medicine
MRSA:Implications in Sports Medicine
  • Staphylococcus aureus, often referred to as “staph”, are bacteria commonly carried on the skin or in the nose of healthy people

Center for Disease Control: MRSA Fact Sheet 2004

staphylococcus aureus
Staphylococcus Aureus
  • Occasionally, staph can cause an infection
  • Staph bacteria are one of the most common causes of skin infections in the US
  • Most of these infections are minor
    • pimples, boils
  • Most can be treated without antibiotics
  • However, staph infections can cause serious infections
    • surgical wound infections, pneumonia

Center for Disease Control: MRSA Fact Sheet 2004

mrsa methicillin resistant staphylococcus aureus
MRSA:Methicillin-Resistant Staphylococcus Aureus
  • In past, most serious staph bacterial infections were treated with a certain type of antibiotic related to penicillin
  • In recent years, treatment of these infections more difficult because staph bacteria have become resistant to various antibiotics, including the commonly used penicillin related antibiotics
  • These resistant bacteria are called methicillin-resistant staphylococcus aureus, or MRSA

Center for Disease Control: MRSA Fact Sheet 2004

where are staph and mrsa found
Where are staph and MRSA found ?
  • Staph bacteria and MRSA can be found on the skin and in the nose of some people without causing illness.

Center for Disease Control: MRSA Fact Sheet 2004

what is the difference between colonization and infection
What is the difference between colonization and infection ?
  • Colonization occurs when the staph bacteria are present on or in the body without causing illnesss
    • ~25-30% of the population is colonized in the nose with staph bacteria at a given time

Center for Disease Control: MRSA Fact Sheet 2004

what is the difference between colonization and infection6
What is the difference between colonization and infection ?
  • Infection occurs when the staph bacteria cause disease in the person
    • People also may be colonized or infected with MRSA, the staph bacteria that are resistant to many antibiotics

Center for Disease Control: MRSA Fact Sheet 2004

who gets mrsa
Who gets MRSA ?
  • Staph bacteria can cause different types of illness
    • skin infections, bone infections, pneumonia, severe life-threatening bloodstream infections, and other illnesses
  • Since MRSA is a staph bacterium, it can cause the same types of infections as staph in general; however, MRSA occurs more commonly among persons in hospitals and healthcare facilities

Center for Disease Control: MRSA Fact Sheet 2004

who gets mrsa8
Who gets MRSA ?
  • MRSA infection usually develops in hospitalized patients:
    • elderly
    • very sick
    • open wound
    • tube going into body
      • IV or catheter
  • MRSA infections acquired in hospitals and healthcare settings can be severe

Center for Disease Control: MRSA Fact Sheet 2004

who gets mrsa9
Who gets MRSA ?
  • Certain factors can put some patients at higher risk for MRSA:
    • prolonged hospital stay
    • receiving broad-spectrum antibiotics
    • being hospitalized in an intensive care or burn unit
    • spending time close to other patients with MRSA
    • recent surgery
    • carrying MRSA in nose without developing illness

Center for Disease Control: MRSA Fact Sheet 2004

who gets mrsa10
Who gets MRSA ?
  • MRSA causes illnesses in persons outside of hospitals and healthcare facilities as well
  • Cases of MRSA diseases in the community have been associated with:
    • Injecting drug users
    • Aboriginals in Canada, New Zealand or Australia
    • Native Americans in US
    • Incarcerated persons
    • Players of close contact sports

Center for Disease Control: MRSA Fact Sheet 2004

community associated mrsa
Community-Associated MRSA
  • Community-associated MRSA infections are typically skin lesions, but can also cause severe illness
  • Most of transmissions appear to be from people with active MRSA skin infections

Center for Disease Control: MRSA Fact Sheet 2004

how common is staph and mrsa
How common is staph and MRSA ?
  • Staph bacteria are one of the most common causes of skin infection in the US and are a common cause of pneumonia and bloodstream infections
  • Staph and MRSA infections are not routinely reported to public health authorities, so a precise number is not known
  • Estimated as many as 100,000 persons are hospitalized each year with MRSA infections
    • only small proportion of these have disease onset occuring in the community

Center for Disease Control: MRSA Fact Sheet 2004

how common is staph and mrsa14
How common is staph and MRSA ?
  • ~ 25-30% of the population is colonized in the nose with staph bacteria at a given time
  • Numbers who are colonized with MRSA at any one time is not known
  • CDC is currently collaborating with state and local health departments to improve surveillance for MRSA

Center for Disease Control: MRSA Fact Sheet 2004

are staph and mrsa infections treatable
Are staph and MRSA infections treatable ?
  • Yes. Most staph bacteria and MRSA are susceptible to several antibiotics
  • Furthermore, most staph skin infections can be treated without antibiotics by draining the sore
  • However, if antibiotics are prescribed, patients should complete the full course and consult their physicians if the infection does not get better

Center for Disease Control: MRSA Fact Sheet 2004

how are staph and mrsa spread
How are staph and MRSA spread ?
  • Staph bacteria and MRSA can spread among people having close contact with infected people
  • MRSA is almost always spread by direct physical contact, and not through the air
  • Spread may also occur through indirect contact by touching objects contaminated by the infected skin of a person with MRSA or staph bacteria
    • towels, sheets, wound dressings, clothes, workout areas, sports equipment

Center for Disease Control: MRSA Fact Sheet 2004

how can i prevent staph or mrsa infections
How can I prevent staph orMRSA infections?
  • Practice Good Hygiene !!!
    • Keep your hands clean by washing thoroughly with soap and water
    • Keep cuts and abrasions clean and covered with a proper dressing until healed
    • Avoid contact with other people’s wounds or material contaminated from wounds

Center for Disease Control: MRSA Fact Sheet 2004

management of staph or mrsa infections in athletic setting
Management of Staph or MRSA Infections in Athletic Setting
  • Cover all wounds
    • if wound cannot be covered adequately, consider excluding players with potentially infectious skin lesions from practice and/or competition until 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
    • pump soap dispensers with antibacterial soap; no bar soap

Center for Disease Control: MRSA Fact Sheet 2004

management of staph or mrsa infections in athletic setting19
Management of Staph or MRSA Infections in Athletic Setting
  • Discourage sharing of towels and personal items
    • 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 sports medicine staff
  • Encourage coaches and sports medicine staff to assess regularly for skin lesions

Center for Disease Control: MRSA Fact Sheet 2004

what should i do if i think one of my student athletes has a staph or mrsa infection
What should I do if I think one of my student-athletes has a staph or MRSA infection ?
  • Consult your team physician !!!

Center for Disease Control: MRSA Fact Sheet 2004

treatment of mrsa infection
Treatment of MRSA Infection
  • Incision and drainage
    • Culture wound
  • Pharmacologic/supportive treatment
    • Minocycline 100 mg po bid x 14 days (Septra DS as alternative)
    • Rifampin 600 mg po qday x 14 days
    • Bactroban: apply to nares bid x 14 days
    • Hibiclens: head to toe bath
    • Wash all bedding/clothes in dilute bleach solution
  • Unresponsive patients
    • Vancomycin IV; Zyvox (linezolid), Cubicin (Daptomycin) IV

Center for Disease Control: MRSA Fact Sheet 2004

references
References

1. CDC. Methicillin-Resistant Staphylococcus aureus infections among competitive sports participants --- Colorado, Indiana, Pennsylvania, and Los Angeles County, 2000—2003. MMWR 2003; 52(33); 793-795.

2. http://dermis.multimedica.de/doia

3. http://dermnetnz.org/bacterial/boils.html

4. www.cubicin.com

5.www.eurekalert.org/pub_releases/2004-10/epr-dsz100104.php

Center for Disease Control: MRSA Fact Sheet 2004