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Previous Volume 352:468-475 February 3, 2005 Number 5 Next

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ABSTRACT

Background Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of infections outside of health care settings. We investigated an outbreak of abscesses due to MRSA among members of a professional football team and examined the transmission and microbiologic characteristics of the outbreak strain.

Methods We conducted a retrospective cohort study and nasal-swab survey of 84 St. Louis Rams football players and staff members. S. aureus recovered from wound, nasal, and environmental cultures was analyzed by means of pulsed-field gel electrophoresis (PFGE) and typing for resistance and toxin genes. MRSA from the team was compared with other community isolates and hospital isolates.

Results During the 2003 football season, eight MRSA infections occurred among 5 of the 58 Rams players (9 percent); all of the infections developed at turf-abrasion sites. MRSA infection was significantly associated with the lineman or linebacker position and a higher body-mass index. No MRSA was found in nasal or environmental samples; however, methicillin-susceptible S. aureus was recovered from whirlpools and taping gel and from 35 of the 84 nasal swabs from players and staff members (42 percent). MRSA from a competing football team and from other community clusters and sporadic cases had PFGE patterns that were indistinguishable from those of the Rams' MRSA; all carried the gene for Panton–Valentine leukocidin and the gene complex for staphylococcal-cassette-chromosome mec type IVa resistance (clone USA300-0114).

Conclusions We describe a highly conserved, community-associated MRSA clone that caused abscesses among professional football players and that was indistinguishable from isolates from various other regions of the United States.

Source Information

From the Division of Healthcare Quality Promotion, National Center for Infectious Diseases (S.V.K., J.C.H., A.S., S.M., B.J., D.L., L.K.M., M.A., G.K., F.C.T., D.B.J.), and the Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office (S.V.K., T.B.), Centers for Disease Control and Prevention, Atlanta; the Departments of Orthopedic Surgery (M.M.) and Internal Medicine (B.G.) and the Department of Internal Medicine, Infectious Diseases Division (V.J.F.), Washington University School of Medicine, St. Louis; the Missouri Department of Health and Senior Services, St. Louis (L.P., D.D.); the BJC Medical Group, St. Louis (B.G.); the St. Louis Rams Professional Football Team, St. Louis (J.A.); and the Office of Disease Control, Santa Clara County Health Department, San Jose, Calif. (S.C.).

Address reprint requests to Dr. Kazakova at the Epidemic Intelligence Service, Division of Healthcare Quality Promotion, National Center for Infectious Diseases, CDC, 1600 Clifton Rd, MS A35, Atlanta, GA 30333, or at srk7{at}cdc.gov.

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