title: Longitudinal Assessment of Colonization With Staphylococcus aureus in Healthy Collegiate Athletes.
abstract: BACKGROUND
  Staphylococcus aureus is the leading cause of skin and soft tissue infections in the United States, and S. aureus colonization increases the risk of infection. Although athletes have a higher risk of infection with S. aureus than the general population, most studies in athletes have not assessed colonization.
  
  
  METHODS
  We conducted a prospective cohort study of Vanderbilt University varsity athletes from August 2008 to April 2010. We assessed nasal and oropharyngeal colonization with methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) strains by obtaining swabs at enrollment and monthly thereafter until the end of the study. The athletes were also monitored for skin and soft tissue infections.
  
  
  RESULTS
  We enrolled 377 athletes and trainers (224 in contact sports and 153 in noncontact sports). The total S. aureus colonization prevalence ranged from 34% to 62%, and for MRSA it ranged from 8% to 29%. The colonization rate in the summer was significantly higher than that in the winter (odds ratio for MRSA [ORMRSA], 1.70 [95% confidence interval (CI), 1.23-2.35]; ORMSSA, 1.38 [95% CI, 1.05-1.82]). Of 603 MRSA isolates, 75% carried the staphylococcal cassette chromosome mec (SCCmec) type IV, and 5% carried the genes encoding Panton-Valentine leukocidin. Nine symptomatic S. aureus infections occurred, 7 of which were between July and September.
  
  
  CONCLUSIONS
  The S. aureus colonization rate is higher than previously reported and fluctuated over time in this prospective cohort of athletes. The higher colonization prevalence during summer might explain the infectious outbreak during the summer months and may represent a key intervention time for preventing S. aureus disease in athletes.
authors.affiliation: Division of Pediatric Infectious Diseases.
authors.forename: Natalia
authors.initials: N
authors.lastname: Jiménez-Truque
authors.affiliation: Division of Pediatric Infectious Diseases.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Saye
authors.affiliation: Division of Pediatric Infectious Diseases.
authors.forename: Nicole
authors.initials: N
authors.lastname: Soper
authors.affiliation: Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Saville
authors.affiliation: Division of Pediatric Infectious Diseases.
authors.forename: Isaac
authors.initials: I
authors.lastname: Thomsen
authors.affiliation: Division of Pediatric Infectious Diseases.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Edwards
authors.affiliation: Division of Pediatric Infectious Diseases.
authors.forename: C Buddy
authors.initials: CB
authors.lastname: Creech
mesh_terms: D056352:Athletes; D002353:Carrier State / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D011446:Prospective Studies; D012621:Seasons; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D055815:Young Adult
keywords: Staphylococcus aureus; athletes; epidemiology; methicillin-resistant Staphylococcus aureus; sports