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MRSA: Risk Factors For Athletes

The greatest number of skin infections including the antibiotic-resistant skin infection or "super bug" known as methicillin-resistant staphylococcus aureus ("MRSA") have been reported in sports with high physical contact like wrestling, football and rugby. But MRSA infections have also been reported among athletes in other sports such as soccer, basketball, field hockey, volleyball, rowing, martial arts, fencing and baseball.

According to the CDC, settings that make it easier for MRSA to be transmitted often involve the 5 C's:

  • Crowding
  • Frequent skin-to-skin Contact
  • Compromised skin (i.e. cuts or abrasions)
  • Contaminated items and surfaces; and
  • Lack of Cleanliness.

Health officials generally agree that sports teams seem most at risk for staph infections such as community-acquired MRSA.

In the sports context, the CDC has identified three factors that are seen as contributing to the outbreaks:

  1. Sports resulting in skin abrasions. Athletes, especially those playing on artificial turf, can suffer turf burns, abrasions and other skin trauma. Turf burns "are just the kind of minor skin injury that MRSA can exploit," according to Elliot Pellman, medical liason for the National Football League. Even in sports with less direct contact, protective clothing can be hot and might chafe skin, resulting in abrasions and lacerations (e.g. fencers reported developing skin rashes frequently under protective clothing).

  2. Sports involving frequent physical contact. Some sports for which MRSA infections have been reported involve frequent physical contact among players (e.g., football and wrestling). Infections can be transmitted easily from person to person with direct contact.

  3. Sports requiring athletes to share heavy protective clothing and equipment. Sports such as fencing have limited skin-to-skin contact but require multiple pieces of protective clothing and equipment, which often might be shared. The use of shared equipment or other personal items that are not cleaned or laundered between uses could be a vehicle for transmission.

Other risks of exposure

Other, less obvious exposure to MRSA can occur when an athlete shares an unwashed towel, shaves with a contaminated item, or shares other personal hygiene items.  Risk can also increase with athletes who share nonsanitized training equipment, whirlpools, and rehab equipment.  

MRSA has been shown to survive for days to months on inanimate objects, and cultures obtained from exercise equipment have been positive for MRSA.

The bottom line: anyone participating in organized or recreational sports should be aware of the signs of possible skin infections and follow prevention measures.

Source: Centers for Disease Control; Weber, Kathleen. "Community-Associated Methicillin-Resistant Staphylococcus aureus Infections in the Athlete." Sports Health: A Multidisciplinary Approach 1 (2009): 405-410.

Updated November 6, 2009