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Optimum Performance: Preventing MRSA outbreak a touchy subject |

Hands on a football

In 2003 several St. Louis Rams players were exposed to a serious infection, Methicillin-resistant Staphylococcus aureus (MRSA), as a result of bacterial contact from turf burns on their elbows, knees and forearms. MRSA, if left untreated, can become life threatening should it spread to internal body organs and muscles, blood, bones and lungs.

“The diagnosis of MRSA is usually made by its clinical appearance (skin boil or abscess) and by taking a culture to identify the organism,” says Dr. Frank Rabito, an infectious disease specialist at East Jefferson General Hospital. “(MRSA) is epidemic in the (global) community and spread by person-to-person contact. The typical manifestation is a painful boil, but the infection can invade tissues and cause necrosis of skin and deeper tissues.”

Mark Letendre, a Major League Baseball certified athletic trainer for 36 years and director of the league’s umpire medical services said, “By definition, MRSA is resistant to some antibiotics. But other kinds of antibiotics still work. Bactrim and Vancomycin are often the first drugs used. Antibiotics, however, aren’t always necessary. If you have a skin boil caused by MRSA, your doctor may just make an incision and drain it.”

A survey of NFL physicians between 2006-08 noted there were 33 reported MRSA infections across the league, including with the Washington Redskins in 2006.

Redskins owner Daniel Snyder in 2006 reportedly told his team’s head certified athletic trainer, Bubba Tyner, to spare no expense to address the issue. Five Redskins players — including defensive lineman Brandon Noble, who almost lost his leg — contracted MRSA.

The team spent $80,000 to remodeling its headquarters, after which Tyner said, “A major, major project, but it was something that had to be done.”

This season a MRSA outbreak struck the Tampa Bay Buccaneers. Guard Carl Nicks (formerly of the Saints), kicker Lawrence Tynes and cornerback Johnthan Banks were diagnosed with MRSA. The Bucs addressed the potentially dangerous and contagious issue by reportedly hiring a ” California-based company to make sure the infection is completely removed from the building.”

Tampa Bay general manager Mark Dominik said in September, “as part of the team’s proactive plan of action, the Buccaneers organization has been working with the world-renowned Duke Infection Control Outreach Network, since September to educate the organization and implement effective infection control policies.”

When contacted by | The Times-Picayune this week for an update on the team’s MRSA status, a Buccaneers spokesman declined comment.

Of note, Tynes was listed on the NFL’s non-football injury list, while Nicks, who was treated and had a recurrence, required surgery. Banks has not had to sit out games.

The NFL Players Association has had a keen eye on the MRSA outbreak in Tampa.

“We have been involved in an ongoing review of the MRSA incidents in Tampa Bay initiated by the concerns we had about the manner in which team officials responded to these cases,” NFLPA Executive Director DeMaurice Smith said. “This underscores the need for a league-wide, comprehensive and standardized infectious disease protocol. It also calls for improved accountability measures on health and safety issues by the NFL over the clubs.”

When asked about their MRSA prevention program, the Saints had no comment.

Grambling football players recently expressed their fears of potentially contacting MRSA. The university responded with a health inspection report from the state department of heath and hospitals.

No doubt MRSA prevention is a sensitive topic.

A colleague who’s a certified athletic trainer for a college program requested anonymity before addressing the issue: “Is a multidisciplinary approach that involves the athletic trainers, equipment staff, strength and conditioning coaches, janitorial services, coaches and student-athletes. The best way to protect is to properly wash and dry workout gear, shower immediately after activity (with antibacterial soap) and make sure you address any disruption of the skin.

“Cleaning of equipment surfaces after each use is a practice that must be followed. It is also very important that you have physicians that understand MRSA and the appropriate antibiotic regimen that should be followed for a quick recovery.”

The Center For Disease Control and Prevention’s recommendations include:

  • At a minimum, hands should be cleaned before and after playing sports and activities such as using shared weight-training equipment, when caring for wounds including changing bandages, and after using the toilet.
  • If hands are not visibly dirty and sinks are not available for hand washing, for example, while on the field of play or in the weight room, alcohol-based hand rubs and sanitizers can be used. Alcohol-based hand rubs with at least 60 percent alcohol content are preferred.
  • Avoid sharing personal items such as towels and razors that contact your bare skin.
  • Do not share ointments that are applied by placing your hands into an open container.
  • Use a barrier (such as clothing or a towel) between your skin and shared equipment like weight-training, sauna and steam-room benches.

Needless to say, a MRSA outbreak at any level of athletic participation is a daunting challenge to eradicate. At the pro football level, it has and will continue to be a game changer — one that can alter the playing field overnight.

Link:  Optimum Performance: Preventing MRSA outbreak a touchy subject |