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The most common injuries that the athletes can meet with during the sports activities are the skin injuries. Nowadays, epidemics of bacterial infections that affect skin take place in amateur and professional sports teams more often. Some skin infections are non-hazardous and can be treated easily, but the others can represent a threat to an infected person’s life. The antibiotic-resistant skin infections are the dangerous ones, and they usually are characterized by the high-level morbidity and in some cases they can even lead to a fatal outcome. Thus, those infections need a special treatment and require the skills of the fast and correct recognition. Methicillin-resistant Staphylococcus aureus (MRSA) infection is one of the most prevalent in the sports environment, and according to the recent reports, nowadays it frequently requires hospitalization. Sports medicine specialists and physicians need to be aware of the new data related to skin injuries and infections in the athletic community to diagnose accurately, efficiently treat skin diseases, and prevent the infection outbreaks.
MRSA: Types, Symptoms, Treatments
MRSA is “an isolate of Staphylococcus aureus characterized by antibiotic resistance to penicillins and cephems, including methicillin, oxacillin, and other narrow spectrum β-lactamase resistant penicillin antibiotics” (Diduch et al. 557). MRSA can develop virulently, and in some particularly severe cases the hospitalization is required for a person diagnosed with MRSA. The several cases of death caused by the infection were reported. The potentiality of the fatal outcomes is taken seriously by the public, and currently MRSA infection research gains more attention.
Nowadays there are two types of MRSA recognized. In the recent past, MRSA was “traditionally viewed as a hospital pathogen,” but nowadays the infection is frequently met in the other communities, and particularly in group sports, such as football, volleyball, wrestling, rugby, etc. (Winterstein 189). Thus, MRSA can be hospital-associated (HA-MRSA) or community-associated (CA-MRSA). The HA-MRSA’s treatment always was problematic and had many issues. This kind of infection “affects primarily those in hospitals and nursing homes, those with immune disorders, and those with recent antibiotic usage” (Micheli 504). These requirements and conditions are not necessary for CA-MRSA, and it can affect even healthy people.
The threat of MRSA is in its virulence and the resistance to several antibiotics. CA-MRSA can be found in the skin lesions caused by many of the known infections, the damage from which is usually mild. “MRSA can be the pathogen involved in many skin conditions,” such as folliculitis, scabies, impetigo, furunculosis and others (Micheli 504). The neglecting of the symptoms and inappropriate treatment can cause the development of MRSA. The cases of the severe skin damage, necrotizing fasciitis and abscesses are often reported. “Fully invasive CA-MRSA is not common, but it can cause significant mortality and disabling outcomes” (Winterstein 189).
CA-MRSA infection can be recognized by skin lesions, “which can appear in a variety of ways including folliculitis, impetigo, mild to moderate cellulitis, large soft tissue abscesses measuring up to 7 cm in diameter, and can occur simultaneously on different areas of the body” (Diduch et al. 559). Sports medicine specialist need to pay attention to the fact that MRSA lesions often imitate other skin and soft tissue lesions. The systemic symptoms such as fever, vomiting, malaise, and nausea should be recognized timely.
The treatment of the infection usually includes the drainage of abscesses and usage of the oral antibiotics. Usually, the treatment procedures can be defined only after obtaining results of culture and antibiotic sensitivity analysis. Hospitalization and surgical treatment, and intravenous antibiotics are required in cases of severe lesions caused by infection. The appropriate treatment of skin and soft tissue lesions is determined by clinical presentation. The period of treatment usually lasts up to 14 days, but it depends directly on the severity of infection and the recovery process. The correct treatment of the individual cases helps to prevent the widespread dissemination of infection that can lead to an outbreak in the community.
The Impact of MRSA on Sports Activities and Professions
Like all the other diseases, skin infections interfere with the athletic activities and performance. Trainers and athletes need to pay a significant attention to any manifestations of skin infections in teams. Even the infections that are in fact do not affect the health severely, without the appropriate medical therapy can become infected with MRSA. In the case of MRSA infection, the diagnosis must be especially quick and correct because “once contracted by one athlete, the disease can transmit rapidly throughout the team,” and so the one athlete can infect the whole team and provoke the infection epidemic (Eaves 216). An athlete who was diagnosed with the symptoms of MRSA infection should be immediately withdrawn from all the sportive activities, and separated from the team members. The medical treatment must be provided for the infected individual. The athletes can return to practice only when the infection lesions are completely dried, the antibiotic treatment is accomplished, and no new lesions appear on his or her skin within 48 hours (Fincher and O’Connor 303).
Along with the individual cases of MRSA infection, the multiple cases of mass infections that occurred in the various US athletic teams since 2003 were reported by the Center for Disease Control and Prevention (Diduch et al. 558). The risk factors that could be responsible for the infection development were sharing the contaminated equipment and towels, skin traumas, and cosmetic shaving. According to the latest research, the main risk factors that cause MRSA infection development are the skin-to-kin contacts, contacts with the contaminated items, crowding, poor hygiene, and the disturbed skin integrity (Fincher and O’Connor 302). Thus, it is evident that the athletic teams are especially prone to the dissemination of infection because of the close and prolonged contacts that are inherent in the sports environment. According to recent reports, the continuance of contacts is crucial for contamination process. The infection is more often passed to the teammates rather than to the opponents in the athletic competitions, and it means that “the repetitive, close contact predisposes players to infection with CA-MRSA” (Diduch et al. 558).
It was proven by many researchers that MRSA is highly contagious. As it was observed, the contamination more often occurred through the physical contacts, and often it occurs on uncovered the parts of the body: elbows, forearms, and knees (Diduch et al. 558). Nevertheless, the areas covered with the clothes are also exposed to infection because of abrasions caused by shaving. Even the superficial abrasions, scratches or traumas make athletes prone to infection. Sharing of the personal athletic equipment and towels also provoke the infection transmitting.
The level of participation of the infected athlete in the sportive activities and competitions is usually determined individually and is dependent on the particular conditions. But it is important to keep the diagnose athlete out of the group and to stick to the safety precautions; otherwise the consequences may be serious.
The criteria that can cause disqualification due to skin disorders are defined by the National Collegiate Athletic Association. The document concerns wrestling because this sport has a “long history of dermatologic issues” (Eaves 216). The football players also meet the high risk of CA-MRSA contamination. According to the latest research the MRSA manifestations are the most common in the football environment, and most of the players are treated with the surgical drainage (Diduch et al. 558).
Since many infections can be transmitted by skin-to-skin contacts, the sportive group activities are at risk. The contamination factors include “exposure to infection, compromised skin integrity, and transmission via person-to-person or person-to-object contact” (Diduch et al. 558). As it can be observed, the infection development within the group of athletes is usually caused by ignorance and lack of compliance with the rules of personal hygiene, inappropriate treatment or the lack of recognition of the individual infections that later develop through the physical contacts.
To prevent CA-MRSA infection one needs to keep up to the rules of the personal hygiene. Athletes need to wash their hands thoroughly, especially before and after treating wounds. It is necessary to take showers after activities. The towels and other personal equipment shouldn’t be shared, and they must be kept clean. The athletes with wounds and lesions must be provided with the proper first aid treatment, and those with the suspicious lesions should be diagnosed. During the participation in athletic activities, even the smallest wounds must be covered (Fincher and O’Connor 302).
It is possible to assume that the risk of dissemination of all the skin infections and disorders can be reduced by proper cleaning of the training rooms, equipment, and facilities. The trainers and athletes must gain awareness of the infection impacts on the sportive performance. Thus, the proper education is required. Athletes must be told to report about abrasions to their coaches or physicians, and the coaches in their turn need must be trained to recognize the symptoms and signs of MRSA infection.
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The treatment of MRSA infections is problematic because it is highly contagious and resistant to the variety of antibiotics. For few decades, the infection often occurs in the athletic communities. CA-MRSA commonly transmitted through physical contacts, the skin traumas also make the transmitting fast. Within the athletic teams, the cases of MRSA infection epidemic are frequent. Usually, the infection development happens because of the noncompliance with the rules of hygiene, the infection symptoms neglecting, and the incorrect treatment. To avoid the infection outbreaks, first of all, the personal hygiene rules must be followed, and the thorough cleaning of the training rooms must be provided. The trainers need to be more alert of the skin infection manifestations among the team members. All the skin lesions have to be treated, and in case if the athlete shows the symptoms of CA-MRSA, he or she must be immediately excluded from the team and participation in the sports activities until the complete health recovery. The timely infections recognition and their appropriate treatment support the reduction in the MRSA proliferation and epidemics.
Diduch, David, Terry Grindstaff, Joseph Hart, John MacKnight, Dilaawar Mistry, Daniel Redziniak, and Kimberly Turman. “Methicillin-resistant Staphylococcus Aureus (MRSA) in the Athlete.” International Journal of Sports Medicine 30 (2009): 557-562. Print.
Eaves, Ted. The Practical Guide to Athletic Training, London, UK: Jones and Bartlett Publishers, 2010. Print.
Fincher, Louise and Daniel O’Connor. Clinical Pathology for Athletic Trainers: Recognizing Systemic Disease. Thorofare, NJ: Slack Incorporated, 2008. Print.
Micheli, Lyle. Encyclopedia of Sports Medicine. London, UK: Sage Publications, 2010. Print.
Winterstein, Andrew. Athletic Training Student Primer: A Foundation for Success. Thorofare, NJ: Slack Incorporated, 2009. Print.