title: A clone of methicillin-resistant Staphylococcus aureus among professional football players.
abstract: 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.
authors.affiliation: Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, GA 30333, USA. srk7@cdc.gov
authors.forename: Sophia V
authors.initials: SV
authors.lastname: Kazakova
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Hageman
authors.forename: Matthew
authors.initials: M
authors.lastname: Matava
authors.forename: Arjun
authors.initials: A
authors.lastname: Srinivasan
authors.forename: Larry
authors.initials: L
authors.lastname: Phelan
authors.forename: Bernard
authors.initials: B
authors.lastname: Garfinkel
authors.forename: Thomas
authors.initials: T
authors.lastname: Boo
authors.forename: Sigrid
authors.initials: S
authors.lastname: McAllister
authors.forename: Jim
authors.initials: J
authors.lastname: Anderson
authors.forename: Bette
authors.initials: B
authors.lastname: Jensen
authors.forename: Doug
authors.initials: D
authors.lastname: Dodson
authors.forename: David
authors.initials: D
authors.lastname: Lonsway
authors.forename: Linda K
authors.initials: LK
authors.lastname: McDougal
authors.forename: Matthew
authors.initials: M
authors.lastname: Arduino
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Fraser
authors.forename: George
authors.initials: G
authors.lastname: Killgore
authors.forename: Fred C
authors.initials: FC
authors.lastname: Tenover
authors.forename: Sara
authors.initials: S
authors.lastname: Cody
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Jernigan
mesh_terms: 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
chemical_list: D005782:Gels