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July 5, 2010

One-Year Surveillance of Methicillin-Resistant Staphylococcus aureus Nasal Colonization and Skin and Soft Tissue Infections in Collegiate Athletes

Author Affiliations

Author Affiliations: Division of Pediatric Infectious Diseases, Department of Pediatrics (Drs Creech and Edwards, Mss Saye, Johnson, and Jimenez, and Mr McKenna), Division of Infectious Diseases, Department of Medicine, and Department of Preventive Medicine (Dr Talbot), and Division of Sports Medicine, Department of Orthopaedics (Mr Bossung and Dr Gregory), Vanderbilt University Medical Center, and Vanderbilt Children's Hospital (Drs Creech and Edwards, Mss Saye, Johnson, and Jimenez, and Mr McKenna), Nashville, Tennessee.

Arch Pediatr Adolesc Med. 2010;164(7):615-620. doi:10.1001/archpediatrics.2010.93

Objective  To determine the frequency and clinical importance of methicillin-resistant Staphylococcus aureus (MRSA) colonization in student athletes.

Design  Prospective observational cohort study.

Setting  A major university in the southeastern United States.

Participants  Student athletes participating in the men's football and women's lacrosse programs (N = 126).

Main Exposure  Monthly assessment of S aureus nasal colonization.

Main Outcome Measures  Trends in S aureus colonization over time and the occurrence of skin and soft tissue infections.

Results  Methicillin-resistant S aureus nasal colonization varied significantly through the athletic season (4%-23%), peaking during times of highest athletic activity. This increase in colonization was not associated with the development of an outbreak of skin and soft tissue infections, and no single MRSA clone emerged as a dominant isolate.

Conclusions  During the athletic season, there is a considerable burden of MRSA colonization in student athletes; however, colonization alone appears to be insufficient to trigger an outbreak of staphylococcal infections. A combination of distinct molecular characteristics in the organism and specific host factors may govern the development of staphylococcal disease.