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| HOT TOPICS |
‘Staph’ skin infections in Sport
CA-MRSA stands for community acquired methicillin resistant staphylococcus aures, an
increasingly more common infection found among athletes. Staphylococcus aureus
(staph) are bacteria commonly living on the skin or in the nares (nose) of healthy
people. About 30% of the population are carriers (colonized without infection). Most
infections caused by staph are skin infections and are not serious. MRSA is a type of
staph that is resistant to antibiotics called beta-lactams which include methicillin,
oxacillin, penicillin and amoxicillin. Approximately 1% of the population is colonized with
MRSA. Making headlines recently, have been outbreaks among professional and high
school sports teams with some serious infections resulting in death.
Staph skin infections present as a pimple or boil. They may be associated with warmth,
redness, and pus drainage. When a pimple or boil rapidly worsens, suspect MRSA.
They are often mistaken for spider bites and treated with incorrect antibiotics in many
cases.
The CDC reports the following factors to be associated with the spread of MRSA skin
infections: close skin-to-skin contact, openings in the skin such as cuts or abrasions,
contaminated items and surfaces, crowded living conditions, and poor hygiene. All
factors common in sports participation.
Staph skin infections are transmitted most commonly by skin to skin contact.
The bottom line: Practice good hygiene:
1. Do not pick your skin or your nose or pick your nose and then your skin.
2. Keep your hands clean by washing thoroughly with soap and water,scrub your
hands for more than 15 seconds.
3. Keep all superficial wounds clean and covered with a bandage until healed.
4. Avoid contact with other people’s wounds.
5. Avoid sharing personal items such as towels, razors, and sports equipment.
6. In the gym wipe off equipment before and after use and have clothing or a towel
between you and the equipment.
If you do contract a staph skin infection or have pimples or boils that pop up and worsen
quickly: seek medical attention, notify your coach, team, and/or trainer, cover your
lesions, keep your hands clean, wash all bedding and personal items in hot water, and
avoid sharing towels, clothing or equipment, and avoid picking at your skin.
Treatment:
If an abscess or boil (collection of pus in walled off space) is present, incision, drainage,
and culture should be performed. Prior to antibiotic sensitivity testing, antibiotics may
be prescribed by your health care provider. If surrounding skin is not angry red warm
infectious appearing (cellulitis), then they may wait and monitor you without antibiotics.
Over prescribing antibiotics for non bacterial infections (such as viral colds) has lead to
bacterial resistance and should be avoided. After incision and drainage, even if culture
comes back positive for MRSA, some infection disease specialists have recommended
in the absence of cellulitis, monitoring without antibiotics to prevent further resistance.
Current antibiotics that may be prescribed for MRSA are Bactroban (topical cream); oral
agents such as: Trimethoprim-Sulfamethoxazole (TMP-SMX or Bactrim DS) with or
without Rifampin, Doxycycline/Minocycline for sulfa allergic patients, or Clindamycin (if
erythromycin resistant only after a lab test called the D-Test is performed to evaluate
for clindamycin resistance); and IV antibiotic such as Vancomycin, Daptomycin, or
Linezolid for disseminated systemic infections.
For recurrent infections, your doctor may culture your nose and treat with nasal
mupirocin (bactroban ointment) to your nares 2x/day for 5 days to try to
eradicate colonization, plus Hibiclens body washes.
Return to play:
No player involved in contact sports may return to play with any new, healing, moist, or
active draining lesions. Some recommend 48 hours of oral antibiotics as well prior to
return. No consensus guidelines exist to date (10/17/07).
For Health Care Professionals:
Link to Johns Hopkins Point of Care Information Technology
CA-MRSA stands for community acquired methicillin resistant staphylococcus aures, an
increasingly more common infection found among athletes. Staphylococcus aureus
(staph) are bacteria commonly living on the skin or in the nares (nose) of healthy
people. About 30% of the population are carriers (colonized without infection). Most
infections caused by staph are skin infections and are not serious. MRSA is a type of
staph that is resistant to antibiotics called beta-lactams which include methicillin,
oxacillin, penicillin and amoxicillin. Approximately 1% of the population is colonized with
MRSA. Making headlines recently, have been outbreaks among professional and high
school sports teams with some serious infections resulting in death.
Staph skin infections present as a pimple or boil. They may be associated with warmth,
redness, and pus drainage. When a pimple or boil rapidly worsens, suspect MRSA.
They are often mistaken for spider bites and treated with incorrect antibiotics in many
cases.
The CDC reports the following factors to be associated with the spread of MRSA skin
infections: close skin-to-skin contact, openings in the skin such as cuts or abrasions,
contaminated items and surfaces, crowded living conditions, and poor hygiene. All
factors common in sports participation.
Staph skin infections are transmitted most commonly by skin to skin contact.
The bottom line: Practice good hygiene:
1. Do not pick your skin or your nose or pick your nose and then your skin.
2. Keep your hands clean by washing thoroughly with soap and water,scrub your
hands for more than 15 seconds.
3. Keep all superficial wounds clean and covered with a bandage until healed.
4. Avoid contact with other people’s wounds.
5. Avoid sharing personal items such as towels, razors, and sports equipment.
6. In the gym wipe off equipment before and after use and have clothing or a towel
between you and the equipment.
If you do contract a staph skin infection or have pimples or boils that pop up and worsen
quickly: seek medical attention, notify your coach, team, and/or trainer, cover your
lesions, keep your hands clean, wash all bedding and personal items in hot water, and
avoid sharing towels, clothing or equipment, and avoid picking at your skin.
Treatment:
If an abscess or boil (collection of pus in walled off space) is present, incision, drainage,
and culture should be performed. Prior to antibiotic sensitivity testing, antibiotics may
be prescribed by your health care provider. If surrounding skin is not angry red warm
infectious appearing (cellulitis), then they may wait and monitor you without antibiotics.
Over prescribing antibiotics for non bacterial infections (such as viral colds) has lead to
bacterial resistance and should be avoided. After incision and drainage, even if culture
comes back positive for MRSA, some infection disease specialists have recommended
in the absence of cellulitis, monitoring without antibiotics to prevent further resistance.
Current antibiotics that may be prescribed for MRSA are Bactroban (topical cream); oral
agents such as: Trimethoprim-Sulfamethoxazole (TMP-SMX or Bactrim DS) with or
without Rifampin, Doxycycline/Minocycline for sulfa allergic patients, or Clindamycin (if
erythromycin resistant only after a lab test called the D-Test is performed to evaluate
for clindamycin resistance); and IV antibiotic such as Vancomycin, Daptomycin, or
Linezolid for disseminated systemic infections.
For recurrent infections, your doctor may culture your nose and treat with nasal
mupirocin (bactroban ointment) to your nares 2x/day for 5 days to try to
eradicate colonization, plus Hibiclens body washes.
Return to play:
No player involved in contact sports may return to play with any new, healing, moist, or
active draining lesions. Some recommend 48 hours of oral antibiotics as well prior to
return. No consensus guidelines exist to date (10/17/07).
For Health Care Professionals:
Link to Johns Hopkins Point of Care Information Technology
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Web design by Marc Silberman MD.
Copyright 2004, New Jersey Sports Medicine and Performance Center LLC. All rights reserved. Disclaimer.
Copyright 2004, New Jersey Sports Medicine and Performance Center LLC. All rights reserved. Disclaimer.
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| Get Better. Faster. |
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