A clone of methicillin-resistant Staphylococcus aureus among professional football players.
BACKGROUND
Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of infections outside of health care settings. We investigated an outbreak of abscesses due to MRSA among members of a professional football team and examined the transmission and microbiologic characteristics of the outbreak strain.


METHODS
We conducted a retrospective cohort study and nasal-swab survey of 84 St. Louis Rams football players and staff members. S. aureus recovered from wound, nasal, and environmental cultures was analyzed by means of pulsed-field gel electrophoresis (PFGE) and typing for resistance and toxin genes. MRSA from the team was compared with other community isolates and hospital isolates.


RESULTS
During the 2003 football season, eight MRSA infections occurred among 5 of the 58 Rams players (9 percent); all of the infections developed at turf-abrasion sites. MRSA infection was significantly associated with the lineman or linebacker position and a higher body-mass index. No MRSA was found in nasal or environmental samples; however, methicillin-susceptible S. aureus was recovered from whirlpools and taping gel and from 35 of the 84 nasal swabs from players and staff members (42 percent). MRSA from a competing football team and from other community clusters and sporadic cases had PFGE patterns that were indistinguishable from those of the Rams' MRSA; all carried the gene for Panton-Valentine leukocidin and the gene complex for staphylococcal-cassette-chromosome mec type IVa resistance (clone USA300-0114).


CONCLUSIONS
We describe a highly conserved, community-associated MRSA clone that caused abscesses among professional football players and that was indistinguishable from isolates from various other regions of the United States.
Kazakova
Sophia V
SV
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, GA 30333, USA. srk7@cdc.gov
Hageman
Jeffrey C
JC
Matava
Matthew
M
Srinivasan
Arjun
A
Phelan
Larry
L
Garfinkel
Bernard
B
Boo
Thomas
T
McAllister
Sigrid
S
Anderson
Jim
J
Jensen
Bette
B
Dodson
Doug
D
Lonsway
David
D
McDougal
Linda K
LK
Arduino
Matthew
M
Fraser
Victoria J
VJ
Killgore
George
G
Tenover
Fred C
FC
Cody
Sara
S
Jernigan
Daniel B
DB
D000038:Abscess / Q000453:epidemiology / Q000382:microbiology*; D000328:Adult; D002999:Clone Cells; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005538:Football; D005782:Gels; D006801:Humans; D006875:Hydrotherapy; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D009666:Nose / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D012867:Skin / Q000293:injuries / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D013211:Staphylococcus aureus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D014481:United States / Q000453:epidemiology
D005782:Gels