title: Ineffectiveness of surveillance to control community-acquired methicillin-resistant Staphylococcus aureus in a professional football team.
abstract: OBJECTIVE
  Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is an increasing problem in athletic populations, with outbreaks spreading among team members. Due to this elevated risk, several strategies have been adopted from nonsports settings to avoid and to control CA-MRSA outbreaks within athletic teams, including the use of surveillance nasal cultures to identify CA-MRSA carriers for decolonization. We sought to assess the effectiveness of such a surveillance program in reducing CA-MRSA infections over 1 season in a professional football team. In addition, we measured the prevalence of CA-MRSA carriage in players with active CA-MRSA infections and conducted a review of the literature for studies, including CA-MRSA nasal carriage surveys in athletic teams.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  Professional football team, San Francisco 49ers.
  
  
  METHODS
  Players and staff of the 2007 San Francisco 49ers (n = 108).
  
  
  METHODS
  Preseason nasal cultures for CA-MRSA were obtained on players and staff of the San Francisco 49ers. Wound and nasal cultures were performed for all participants with suspected CA-MRSA infections throughout the season.
  
  
  METHODS
  Nasal and wound cultures positive for CA-MRSA.
  
  
  RESULTS
  Of 108 total subjects screened on the first day of the 2007 season, 0 cultures were positive for methicillin-resistant Staphylococcus aureus (MRSA). A total of 5 culture-confirmed CA-MRSA infections occurred during the course of the season. Zero of these 5 players had positive MRSA nasal cultures at the time of infection.
  
  
  CONCLUSIONS
  Despite the success of surveillance nasal screening in controlling MRSA outbreaks in hospital settings, this strategy is ineffective in athletic populations.
authors.affiliation: Department of Orthopaedic Surgery, Sports Medicine Center, Stanford University School of Medicine, Stanford, California 94305-6175, USA. garza@stanford.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Garza
authors.forename: Gannon
authors.initials: G
authors.lastname: Sungar
authors.forename: Tyler
authors.initials: T
authors.lastname: Johnston
authors.forename: Brice
authors.initials: B
authors.lastname: Rolston
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Ferguson
authors.forename: Gordon O
authors.initials: GO
authors.lastname: Matheson
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D056352:Athletes / Q000706:statistics & numerical data*; D002353:Carrier State / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000517:prevention & control; D005538:Football; D006801:Humans; D015994:Incidence; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D011446:Prospective Studies; D012495:San Francisco / Q000453:epidemiology; D018571:Sentinel Surveillance; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents