title: Recommendations for Best Disinfectant Practices to Reduce the Spread of Infection via Wrestling Mats.
abstract: BACKGROUND
  At the request of the National Wrestling Coaches Association and the head wrestling coach at our university, we conducted a study of infection transmission in collegiate wrestlers.
  
  
  OBJECTIVE
  To examine disinfectant effectiveness and develop best-practice guidelines for minimizing the spread of skin infections via wrestling mats.
  
  
  METHODS
  Controlled laboratory study and crossover study.
  
  
  METHODS
  Laboratory and two 15-college wrestling invitational meets.
  
  
  METHODS
  A total of 231 collegiate wrestlers and 8 officials.
  
  
  METHODS
  In the laboratory-based part of the study, we measured the bacterial load of mats disinfected with 10% bleach, OxiTitan, Benefect, eWater, and KenClean and inoculated with Staphylococcus epidermidis (strain ATCC 12228) at a concentration of 6.5 × 104bacteria/cm2. In the empirical part of the study, we used these disinfectants during 2 invitational meets and measured mat and participant bacterial load during competition. Participants were swabbed at weigh-in and after their last bout. Mat bacterial load was monitored hourly.
  
  
  METHODS
  We determined total colony counts and species.
  
  
  RESULTS
  With controlled testing, we observed that products claiming to have residual activity reduced bacterial load by 63% over the course of competition compared with nonresidual agents. Only 4 of 182 participating wrestlers tested positive for methicillin-resistant Staphylococcus aureus , which is the normal population occurrence. The predominant species on mats were skin bacteria ( Staphylococcus epidermidis ) and substantial levels of respiratory bacteria ( Streptococcus pneumoniae ), as well as several soil species and a surprisingly low incidence of fecal bacteria ( Escherichia coli ). Disinfectant effectiveness during the meets was consistent with controlled study findings. Cleaning mats with residual disinfectants reduced the average bacterial load by 76% compared with nonresidual cleaners. Using a footbath did not reduce the bacterial load compared with a bleach-cleaned mat, but using alcohol-based hand gel reduced it by 78%.
  
  
  CONCLUSIONS
  Best practices based on these data include backward mopping of the mats with a residual disinfectant pulled behind the cleaner, allowing mats to dry before walking on them, having wrestlers use hand gel before each bout, and strongly recommending that all wrestlers receive annual influenza vaccinations.
authors.affiliation: Department of Biological and Allied Health Sciences, Ohio Northern University, Ada.
authors.forename: Linda Mull
authors.initials: LM
authors.lastname: Young
authors.affiliation: Department of Biological and Allied Health Sciences, Ohio Northern University, Ada.
authors.forename: Vicki Abram
authors.initials: VA
authors.lastname: Motz
authors.affiliation: Department of Biological and Allied Health Sciences, Ohio Northern University, Ada.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Markey
authors.affiliation: Department of Nursing, Ohio Northern University, Ada.
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Young
authors.affiliation: Department of Human Performance and Sports Sciences, Ohio Northern University, Ada.
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Beaschler
mesh_terms: D018592:Cross-Over Studies; D004203:Disinfection / Q000379:methods*; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D012874:Skin Diseases, Infectious / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission*; D019876:Sports Equipment / Q000009:adverse effects*; D014495:Universities; D014952:Wrestling
keywords: bacterial transmission; best practices; decontamination; disinfection; infection prevention