policy paper erica nicole

Prevention of CA-MRSA in College Level Athletes
By: Nicole Van Heek and Erica Luetje
Background
Methicillin resistant S. aureus (MRSA) is a potentially dangerous type of staphylococcus bacteria that is resistant to certain antibiotics and may cause skin and other infections (1). MRSA was widespread in hospitals by the late 1960s, but it appeared rapidly and unexpectedly in communities in the 1990s and is now prevalent worldwide (2).
There are many types of MRSA bacteria that can be transmitted in the hospitals but there is also MRSA bacteria that can be transmitted in the community (CA-MRSA). CA-MRSA infections are usually manifested as skin infections such as pimples and boils that often appear red, swollen, painful or have pus associated with them (3). This type of infection commonly occurs at sites of visible skin trauma such as cuts and abrasions. It can also occur in sites with hair on the body such as the back of the neck, groin, buttock, arm pit, or the bearded area of men (4).
CA-MRSA can be transmitted by sharing razors, towels, and other personal items. However, the number one way to acquire CA-MRSA is by person to person contact (1). Athletes that participate in high physical contact sports such as wrestling, football, soccer and basketball are at high risk for acquiring CA-MRSA because these sports require a high amount of skin to skin contact. Breaks in the skin such as cuts and abrasions, which if left uncovered, allow staphyloccus and MRSA to enter and cause infection (5). Open wounds are the most common way MRSA is spread in athletic settings.

Policy
In order to decrease the amount of CA-MRSA transmission in NAIA college sports, it should be required that all athletes who have an open wound infection must see a physician to obtain a culture before they can participate in any practices or games. There are no regulations requiring culture checks among athletes with these types of infections, but by doing this, it will prevent the spread of CA-MRSA transmission in NAIA athletic settings. To enforce this policy, athletes should report possible infections to coaches, athletic trainers and school nurses so an appointment can be made with a physician for a culture check.
The cost of MRSA culture is approximately $104 per person. Because of the expense, it is important for athletes who only have infected wounds to obtain a culture. Health insurance companies need to be aware of this policy and provide adequate funding for a culture check.
If the athlete tests positive for CA-MRSA, he/she is prohibited from participating in any NAIA sport or practice and must be treated immediately. The athlete cannot compete in NAIA games or practices until CA-MRSA is fully treated and can no longer be transmitted. Athletes that test negative for CA-MRSA can still participate in NAIA practices and games, but are required to keep the wound covered and contained.
All NAIA athletes need to be aware of these antibiotic-resistant bacteria and use preventative methods to decrease the risk of acquiring CA-MRSA. Some prevention include: wash hands often, do not share personal items, disinfect all protective gear and helmets, wash all uniforms and clothing after each use and shower immediately after exercise (5).
Conclusion
Methicillin resistant S. aureus (MRSA) is a potentially dangerous type of staphyloccus bacteria that is resistant to certain antibiotics and may cause skin and other infections . Many athletes are vulnerable to MRSA because of skin to skin contact. By having culture checks on athletes with open wound infections, the spread of CA-MRSA will be reduced significantly in NAIA sporting activities. Many coaches may disagree with this policy because it can prevent key athletes from participating in practices and games when they are needed most. Another concern would be the expense of a culture check. Many health insurance companies may refuse to help cover for a culture check. However if an athlete does not obtain a culture check, this could be dangerous not only for the athlete but also for the team and other opposing NAIA teams. Although athletes and coaches may not be compliant with this policy, in the long run it will benefit all members who compete in the NAIA college level.

References
1. “National MRSA Education Initiative: Preventing MRSA Skin Infections”
Journal of Infectious Diseases (2008).
2. Deleo, Frank R.; Chambers Henry F. “Remergence of antibiotic-resistant Staphl ycoccus aureus in the genomics era.” Journal of Clinical Investigation (2009).Vol.23/No.6
3. “Community-Associated Methicillin Resistant Staphylococcus aures (CA-MRSA)”. Centers for Disease Control and Prevention. Journal of Infectious Diseases (2009).Vol.11/No.4
4. Hageman, Jeff. “Methicillin-resistant Staphylococcus aures (MRSA)”. Centers for Disease Control and Prevention. Journal of Infectious Diseases (2007).Vol. 55/No.24
5. “About Methicillin-Resstant Staphylococcus aureus (MRSA) among Athletes.” Centers for Disease Control and Prevention. Journal of Infectious Diseases (2008). Vol.52/No.33

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