SPORTS MEDICINE
MRSA or Methicillin Resistant Staphylococcus Aureus is a strain of the common staph bacteria routinely found in our environment and on our skin that is resistant to commonly used antibiotics such as penicillin, oxacillin, and amoxicillin.
MRSA infections are common in the community and in healthcare facilities where they may be very serious and potentially life threatening.
Most MRSA infections are found in the community and present as skin infections. They may present as a solitary lesion or multiple lesions. They can worsen to more of a systemic infection rapidly in the sick, elderly and immune compromised. These infections can be seen anywhere but most commonly affect areas of skin breakdown such as abrasions, sores, and surgical wounds.
The spread of MRSA infections is usually caused by skin to skin contact with an infected area. The sharing of personal items such as razors, towels, and bedding can also cause the spread of infections through an opening in the skin. Athletic wraps and shared gym surfaces are also common areas where multiple infections can be initiated. The best prevention is good hygiene with an antibacterial soap and water.
The prevention of MRSA is best achieved with an awareness of how it may be spread especially in areas of high human traffic and shared surfaces such as a gym or locker room. Surfaces must be cleaned routinely with EPA approved sanitizers for MRSA and used according to direction and duration. Standard household bleach is effective when used at the correct dilution. Areas of high daily volume of skin contact should be targeted such as mats, counters, athletic equipment etc.
In the athletic population, the best prevention is education, good hygiene, proper skin care and emphasis on avoiding sharing of towels and equipment.
In the community or school setting, MRSA cutaneous infections may take on different looks. Most often they will appear around open wounds, scratches, and hairy areas of the body. They will present as pustules, large pimples or boils that are red and tender. Some will present with draining pus. The surrounding skin may become cellulitic and swollen. Many times the lesions are confused as ingrown hairs, or insect bites.
In the athletic population, suspected MRSA infections should be reported rapidly to prevent serious complications and to minimize time out of sport. Any suspected lesion should be covered with a dressing until examined by a healthcare provider. Diagnosis is made by obtaining a skin sample or fluid sample for culture. The treatment of skin lesions requires drainage followed by oral antibiotics to completion in minor cases but I.V. antibiotics in more serious cases. The athlete with a confirmed cases of cutaneous MRSA should receive treatment and not return to play until the lesion is no longer draining and healed to avoid spread of the infection.
Ken Furcolo, PA-C
