Please realize how much more valuable these suggestions and guidelines to athletes would be if they were informed about oral and topical use of ACS 200.

The whole problem becomes entirely manageable instantly but I fear that the reasons for this outbreak are much more complex and ominous.

Garry F. Gordon MD,DO,MD(H)
President, Gordon Research Institute
http://www.gordonresearch.com



Any sports medicine specialists:
Locker Room–acquired MRSA

http://www.orthosupersite.com/view.asp?rID=37500

By Darren L. Johnson, MD
ORTHOPEDICS 2009; 32:180
In this issue of ORTHOPEDICS, Dr Darren L. Johnson discusses the risk of methicillin-resistant Staphylococcus aureus (MRSA) skin infections in athletes.

Why does methicillin-resistant Staphylococcus aureus (MRSA) occur in athletes?
Many risk factors for MRSA infections have been identified. While these are not specific to athletic populations, athletes may encounter them more frequently than the general population. Among these risk factors, skin abrasions and the sharing of training equipment or personal hygiene items are commonly identified as potential risks for developing MRSA infections in athletes.

Should athletes with MRSA skin infections be excluded from participation?
Athletes with MRSA skin infections need to be treated promptly. Exclusion from participation depends on the severity of the infection and the specific sport. Athletes with systemic symptoms (fever and chills) and evidence of spreading infection (cellulitis) should be restricted from activity. Athletes without systemic symptoms may be able to participate in athletics but are typically handled on a case-by-case basis. Also, specific sports such as wrestling preclude participation with open wounds.

Which athletes are most at risk for MRSA skin infections?
Athletes who participate20in contact sports such as football with prolonged physical contact are more likely to acquire MRSA infections.

What do you believe has led to the increase in locker room–acquired MRSA infections?
The increase is likely the result of increased recognition on the part of the medical staff. Previously, local skin infections had been labeled as infected insect or spider bites, when in fact they were likely MRSA skin infections. The increase in MRSA infections in athletes also mirrors that of other at-risk populations, like military and prison populations.

What is the role of the team physician with regard to the prevention of MRSA in the locker room?
The team physician’s role in the prevention of community–acquired MRSA (CA-MRSA) infections should primarily center on education. Athletes and staff need to be educated about MRSA and the importance of hygiene and not sharing personal items. Even minor skin abrasions should be reported to the medical staff. Disinfection of training room common areas needs to be performed on a daily basis. Regular policy reviews regarding prevention measures should be carried out as well.

Until the beginning of this decade, MRSA was confined almost exclusively to hospitals. The past few years have seen cases rise among the general public, particularly where large numbers of people are in close proximity, such as athletic teams. Can this be explained?
The emergence of CA-MRSA as a significant public health issue dates back to the 1990s. It has become more widely noticed and documented in the athletic community over the past several years with well-publicized outbreaks occurring in professional and collegiate athletic teams. The increased prevalence is likely related to the development of antibiotic-resistant strains in the CA-MRSA organisms. These strains are genetically different from those encountered in hospital–acquired MRSA infections.

What steps can be taken to prevent deaths resulting from MRSA infections?
Expedient identification and aggressive treatment of CA-MRSA infections can help limit morbidity and mortality. Incision and drainage of abscesses and culture-directed antibiotic treatment are the mainstays of treatment. For individuals with systemic symptoms, hospitalization and intravenous antibiotics should be considered.

Author
Dr Johnson is professor and chairman, Department20of Orthopedic Surgery, and Director of Sports Medicine, University of Kentucky School of Medicine, Lexington, Kentucky.