A Longitudinal Study Of Community-Associated Methicillin-Resistant Staphylococcus aureus Colonization In College Sports Participants

Abstract

Staphylococcus aureus is the leading cause of invasive infections and skin and soft tissue infections in the United States. Athletes have higher risk of infection with S. aureus than the general population. Though carriage of S. aureus increases the risk of infection, most studies in athletes have not assessed carriage and have included mostly male contact sports participants. Thus, the natural history of carriage in different sports is poorly understood, and strategies to prevent infections in athletes are not clear. To better understand carriage of S. aureus and to identify its risk factors, we collected nasal and throat samples from all Vanderbilt University varsity athletes for two academic years. Staphylococcal carriage was highest during the summer. Contact sports athletes had higher risk of carrying S. aureus over time: they had higher carriage and they carried S. aureus for longer periods of time than athletes in noncontact sports. Also, athletes acquired S. aureus more quickly if they played contact sports. Athletes in contact sports, and particularly in football, were more likely to carry the current epidemic clone of MRSA (USA300) that is associated with substantial morbidity and mortality. These findings indicate that contact sports participation, particularly football, increases athletes’ risk of carrying S. aureus. These findings also suggest that efforts to prevent transmission of S. aureus among athletes should be focused on contact sports teams after the summer break, when carriage was highest.