Prevalence of Methicillin-Resistant Staphylococcus aureus in 4A and 5A High Schools in Texas UIL Region IV Fall 2004

1
Prevalence of Methicillin-Resistant
Staphylococcus aureus in 4A and 5A High Schools
in Texas UIL Region IV Fall 2004

• By
• Carolina Espinoza
• Public Health Internship - Spring 2005

2
Objective

• Determine the prevalence of MRSA infections in
  Texas 4A and 5A UIL Region IV High Schools by
  surveying Licensed Athletic Trainers through mail
  and phone questionnaires.
• Investigate which athletic program sectors are
  affected.

3
Introduction
4
Important Facts

• Staphylococcus aureus (Staph)
• - Common bacteria
• - Acquired mainly through direct contact
  (individuals and objects)
• - Asymptomatic carriers
• - Found in nose, armpit, groin, and other
  similar areas
• - Causes soft tissue infections such as boils
  and impetigo
• - Can cause pneumonia and bloodstream infections
• - Treatable with antibiotics

5
Methicillin-resistant Staphylococcus aureus (MRSA)

• MRSA
• - Cannot be treated with common penicillin-like
  antibiotics
• - In the past confined to hospitals, nursing
  homes, long-term care facilities
• CA-MRSA Community-Associated MRSA
• - Movement into the community
• - Affecting athletes

6
History of Staph MRSA in Athletes

• 1984 - rugby team in London
• 1986 - outbreak of boils in football and
  basketball Kentucky
• 1993 - 1st case of MRSA in a wrestling team in
  Vermont
• 2002 - 03 MRSA boom!!!
• -Los Angeles county athletes county jail
• -Colorado, Indiana, and Pennsylvania fencers,
  football, wrestlers
• 2004 - 05 high school, college, professional
  football and basketball

7
Methodology
8
Groups in the Study

• Athletic Program Sectors
• Athletes
• Football
• Volleyball
• Wrestling
• Cross Country
• Non-Athlete Students student team managers and
  student athletic trainers
• Adults coaches, athletic trainers, and other
  staff working closely with athletes

9
Questionnaire Sample
10
Results
11
(No Transcript)
12
(No Transcript)
13
(No Transcript)
14
(No Transcript)
15
  Number of Skin, Staph, and MRSA Infections
Reported in Texas 4A and 5A UIL Region IV High
School According to Athletic Program Sector  
N number of infections
16
(No Transcript)
17
Range of Skin, Staph, and MRSA Infections
Reported in 4A and 5A Texas UIL Region IV High
Schools According to Athletic Program Sector    
18
Discussion
19
Football and Wrestling

• Most Affected Athletic Program Sectors
• - Football (more participants)
• - Wrestling (higher percentage)
• Most likely due to
• - Contact sports (person to person transmission)
• - Increased risk of lesions as well as turf and
  mat burns
• - Sites of infections go unnoticed
• - Sharing of unclean equipment and/or personal
  items

20
Volleyball and Cross Country

• Emerging
• - Volleyball high number of reported infections
• - Cross country few reported infections
• Cause of concern
• - Volleyball low contact sports
• - Cross country non-contact sport
• - Possibly the first reported cases

21
Adults and Non-Athlete Students

• Emerging
• - Individuals not directly participating in
  competition being affected
• - Adults are being affected more than some
  sports sectors
• - Non-athlete students seem to be the least
  affected
• Most likely due to
• - Adults fix, dress, and wrap athlete wounds
• - Non-athletes clean up equipment and clean up
  after players

22
EDUCATION!!!
23
Recommendations to Prevent MRSA Infections

• For All Adults and Students
• - Stress the importance of HAND WASHING and
  hygiene
• - Keep wounds covered and dispose of bandages
  properly
• - Eliminate sharing of equipment and personal
  items
• - Stress clean facilities

24
Summary

• MRSA is prevalent in Texas 4A and 5A UIL Region
  IV High Schools throughout various athletic
  programs sectors except for
• non-athlete student.
• As expected based on previous reports Football
  and Wrestling are currently the greatest at
  risk!!!!

25
A Special Thanks to

• My mentors Marilyn Felkner, DrPH and Jeff Taylor,
  MPH for all their constant advice and continual
  support.
• Hermia Brooks.
• All the 4A and 5A High School Athletic Trainers
  who responded to our questionnaire.
• The Texas Department of State Health Services.
• The Texas Health Foundation for providing
  funding.