Assessment of Athletic Health Care Facility Surfaces for MRSA in the Secondary School Setting by ProQuest


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									                                                    A d v A N c E M E N T O f T H E Science

                                            Assessment of Athletic Health
                                            Care Facility Surfaces for MRSA
                                            in the Secondary School Setting
                                                                                                                      Kyle montgomery, LAt, Atc
                                                                                                                  timothy J. ryan, Phd, cIh, cSP
                                                                                                                   Andrew Krause, Phd, LAt, Atc
                                                                                                                     chad Starkey, Phd, LAt, Atc

                                                                                                            Legitimate concerns exist about MRSA in
    Abstract                Methicillin-resistant Staphylococcus aureus (MRSA)
                                                                                                         the community at large, especially within
                                                                                                         the athletic setting. CA-MRSA soft tissue
    was once largely a hospital-acquired infection, but increasingly, community-                         and skin infections have been identified
    associated MRSA (CA-MRSA) is causing outbreaks among otherwise healthy                               in volleyball, football, fencing, rugby, and
    people in athletic settings. Secondary school athletic trainers, student ath-                        wrestling athletes (Beam & Buckley, 2006;
    letes, and the general student population may be at elevated risk of MRSA in-                        Cohen & Kurzrock, 2004). In these out-
                                                                                                         breaks, shared clothing, sports equipment,
    fection. To identify the prevalence of MRSA on surfaces in high school athletic
                                                                                                         towels, balms, lubricants, razors and soaps,
    training settings, 10 rural high school athletic training facilities and locker                      improper care of skin trauma, direct skin-
    rooms were sampled for MRSA. Results showed 90% of facilities had two                                to-skin contact with MRSA lesions, artificial
    or more positive MRSA surfaces, while one school had no recoverable MRSA                             turf burns, and crowded living conditions
    colonies. Of all surfaces tested (N = 90), 46.7% produced a positive result.                         were all identified as risk factors for MRSA
                                                                                                         acquisition. Along with the sources listed,
    From this limited sample, it is evident that significant exposure opportunities
                                                                                                         many other opportunities for transmission
    to MRSA exist in athletic training clinics and adjacent facilities for both the                      of CA-MRSA are plausible. Surfaces within
    patient and the clinician. Furthermore, the findings point to the need for com-                      the athletic training setting, when not appro-
    munity hygiene education about skin and soft tissue infections like MRSA.                            priately disinfected, could possibly be reser-
                                                                                                         voirs of CA-MRSA for the local community.
                                                                                                            Recent outbreaks of CA-MRSA have been
                                                                                                         reported outside of more traditional health
Introduction                                           related to exposures in health care delivery,     care settings, including outbreaks among ath-
Methicillin-resistant Staphylococcus au-               and approximately 85% of all invasive MRSA        letic teams (CDC, 2002, 2003a, 2003b; Cohen
reus (MRSA) is becoming more prevalent in              infections are associated with health care        & Kurzrock, 2004; Lindenmayer, Schoenfeld,
health care settings, and MRSA has recently            (Centers for Disease Control and Prevention       O’Grady, & Carney, 1998; Nguyen, Mascola,
emerged as a growing issue and challenge for           [CDC], 2007). An increasing number of cas-        & Bancroft, 2005). High school athletes seem
allied health care providers (Beam & Buckley,          es, however, is occurring outside of hospitals.   particularly prone to exposure to CA-MRSA
2006). Once primarily the concern of infec-            Data from a study in 2003 suggested that 12%      given their elevated exposure to the exposure
tion control practitioners, MRSA is poised             of clinical MRSA infections were community        routes or fomites listed above. It is important
to become a major issue for athletic trainers,         associated (known as CA-MRSA). Of these,          to point out that most MRSA outbreaks among
sanitarians, and public health officials as well.      approximately 14% occurred in persons with-       athletic teams have been linked to communi-
According to the Centers for Disease Control           out obvious exposures to health care. Con-        ty-acquired strains, as opposed to health care
and Prevention (CDC), the proportion of in-            versely, strains traditionally associated with    varieties (CDC, 2002, 2003a, 200
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