Using teamwork: Athletes at risk for developing MRSA

August 1, 2008

Athletes who participate in team sports are at an elevated risk of developing certain skin conditions, such as methicillin-resistant Staphylococcus aureus. Team physicians should be checking for contagions, such as fungi on the body, and ensure athletes shower after practice and wear clean, dry clothing.

Key Points

National report - One of the biggest dermatological threats in team sports is the potential spread of methicillin-resistant Staphylococcus aureus (MRSA), according to an associate professor at Wright State University in Dayton, Ohio.

"People are taking measures such as cleaning and disinfecting equipment to prevent the spread of MRSA," says Jeffrey Petersen, M.D., who also acts as a consultant to various sports teams and has been a competitive wrestler himself.

"We need to evaluate and treat the individual athlete who may carry the disease, as well as assuring the equipment that they are using is safe," Dr. Petersen tells Dermatology Times.

Treating disease

Dr. Petersen says when acne is abnormal, athletes need to be treated for it, because the acne can harbor bacteria, such as MRSA, and they can spread it to other athletes.

"You need to treat the disease (acne)," Dr. Petersen says, suggesting that therapies such as tetracycline, topical retinoids and even Accutane (isotretinoin, Roche) may be prescribed. "If they have bad acne, make sure that it gets treated," he says.

If the acne is not responding to treatment, it is a wise step to culture the skin to evaluate whether staph is present, Dr. Petersen says.

Athletes that present with cold sores can transmit the herpes virus to other members of the team, and prophylactic therapy should be administered to avoid the spread of oral herpes, according to Dr. Petersen.

"If I see a wrestler who is getting cold sores frequently, I keep the athlete on an antiviral agent throughout the season, such as Valtrex," he says.

Parents of athletes in middle school and high school may choose to discontinue allowing their children to participate in a sport if measures are not taken to stem the potential for an outbreak of MRSA or herpes virus.

"Their reaction may be that they don't want their child to participate anymore if their child comes back from practice with ringworm or a cold sore," he says.

Team physicians should be checking athletes for other contagions, such as fungi on the body, Dr. Petersen says.

Hygiene

"We make sure that our athletes have showered after their practice, and we also make sure they wear open-toe shoes after they get out of the shower," Dr. Petersen says.

"If kids have sweaty feet, we encourage them to change their socks two or three times a day," he says.

Regular cleaning of clothes is mandatory in order to minimize outbreaks of skin conditions in a sports team.

"The clothes that they practice in have to be washed and dried daily," Dr. Petersen says. "These steps minimize the potential for spread of fungi and other diseases."

Judgment call

It's a team physician's judgment call to determine whether a player should bow out of a team practice because of a skin condition.

If an athlete has a wart, it's rarely a condition that will spread over the body and be transmitted to other players.

The same principle applies to athletes who may have a rash that appears to be a type of contact dermatitis. Allowing them to continue to play is probably a judicious move.

"The exception would be if the athlete is secondarily infected," Dr. Petersen. "If I see pus-filled blisters, that is a sign that the athlete has a secondary infection. If I see that on an athlete's skin, I'd recommend that the athlete not practice."

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