title: Methicillin-resistant Staphylococcus aureus infections in collegiate football players.
abstract: OBJECTIVE
  Methicillin-resistant Staphylococcus aureus (MRSA) has been recognized as a serious skin infection in the athletic population. Literature in reference to football players has been sparse. We sought to better elucidate circumstances surrounding such infections in collegiate football players.
  
  
  METHODS
  Data from three Division-I collegiate football programs were consolidated and analyzed. Variables included presence of MRSA infection, timing of occurrence, body location involved, lesion morphology, need for surgical treatment, and antibiotic route. Data were analyzed statistically to evaluate player position, body location, and timing of occurrences.
  
  
  RESULTS
  Of the 491 collegiate football players, 33 (6.7%) were diagnosed with MRSA infections. Cutaneous manifestations included abscess (70%), cellulitis (16%), folliculitis, impetigo, and necrotizing fasciitis. Of the infections, 90% underwent surgical drainage, whereas 27% received intravenous antibiotics. Extremity infections (n = 30) greatly exceeded truncal infections (n = 7); the most common locations were the elbow (n = 11), knee (n = 6), leg (n = 4), and forearm (n = 4). There was no difference in occurrence by player position. Infections occurred predominantly in the first third of the season (P < 0.001, chi-square test) and significantly decreased as the season progressed.
  
  
  CONCLUSIONS
  MRSA infections involving football players are becoming more common. This study documents player positions involved, timing of occurrence in the season, location and type of infections, and required treatment. Exposed extremities may predispose to infection due to risk for minor trauma and direct contact with bacteria. As infection risk seems to be independent of position, all players should observe protective measures. Although most infections occur earlier in the season, physicians should remain alert for infection occurrences throughout the season.
authors.affiliation: Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Bowers
authors.forename: G Russell
authors.initials: GR
authors.lastname: Huffman
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Sennett
mesh_terms: D000328:Adult; D005538:Football; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D014481:United States / Q000453:epidemiology; D014495:Universities / Q000706:statistics & numerical data