Community-associated Methicillin-Resistant Staphylococcus aureus Infection Rates and Management among Student-Athletes

PURPOSE: Although community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections have reduced among inpatient populations, the incidence in athletics continues to range greatly dependent on the sport. Over the 2015 to 2016 and 2016 to 2017 school years, we assessed the annual CA-MRSA incidence, sport risk, referral practices, and management protocols or interventions among high school and intercollegiate athletics. METHODS: This study targeted high school and intercollegiate athletic programs across the United States. For the 2015 to 2016 study, 269 athletic trainers completed a one-time questionnaire. In the 2016 to 2017 study, 217 athletic trainers reported data bimonthly during the academic year. Each questionnaire targeted demographic information, physician-confirmed CA-MRSA infection occurrence, and management of CA-MRSA infections and bacterial skin lesions. RESULTS: The CA-MRSA infection incidence was 26.8 per 10,000 athletes (95% confidence interval CI, 24-30) in 2015-2016 and 20.3 per 10,000 athletes (95% CI, 18-23) in 2016-2017. The CA-MRSA infection incidence was high in wrestling and football compared to the general student-athlete population. During the 2015 to 2016 study, the wrestling incidence rate was 248.3 per 10,000 (95% CI, 204-302); the football incidence rate was 71.0 per 10,000 (95% CI, 60-85). In the 2016 to 2017 study, the wrestling incidence rate was 100.0 per 10,000 (95% CI, 66-151); the football incidence rate was 81.8 per 10,000 (95% CI, 68-99). At least 23% of respondents denoted at least one physician-confirmed CA-MRSA infection within their populations (2015-2016, 39%, n = 105; 2016-2017, 23.5%, n = 51). In the 2015 to 2016 survey, respondents indicated that athlete education and environmental decontamination were the most used management steps (51.8%, n = 582). CONCLUSIONS: Despite increased awareness of CA-MRSA, more educational efforts focusing on best practices and education are needed, especially with athletes and the medical community involved in their care.