Page 128 - Athletic Health Handbook
P. 128
eliminate MRSA in colonized indi- Table 1: Measures for preventing staphylococcal skin infections
viduals. In order to eradicate the among sports participants
bacteria in those persons identified as
carriers in multiple body areas, a five- Cover all wounds. If a wound cannot be covered adequately,
day regimen of intranasal mupirocin consider excluding players with potentially infectious skin lesions
combined with octenidine or chlorhex- from practice or competition until the lesions are healed or can
idine body wash, has been shown to be adequately covered.
be effective.
Encourage good hygiene, including showering and washing with
Surgical debridement of necrotic soap and water after all practices and competitions.
tissue resulting from a MRSA skin
infection can often be performed in Ensure availability of adequate soap and hot water.
the office setting due to the superfi-
ciality of these wounds. Open packing Discourage sharing of towels and personal items (e.g., clothing
of the wound with daily dressing or equipment).
changes using Iodoform gauze, and
closure by secondary intention is often Establish routine cleaning schedules for shared equipment.
successful. Complete wound closure
typically occurs within 10–14 days. Train athletes and coaches in first aid for wounds and recognition
Athletes may be allowed to compete of wounds that are potentially infected.
following wound debridement as long
as the lesion is thoroughly covered, Encourage athletes to report skin lesions to coaches and encourage
remains clean, and is not on a part of coaches to assess athletes regularly for skin lesions.
the body exposed to frequent trauma.
Medical personnel should change Table 2: Treatment of potentially-infected skin wounds in
the wound packing following each the athlete
athletic event or practice.
Maintenance of good hygiene and avoidance of contact with drainage
Preventing Spread of Infection from skin lesions of other players. This appears to be the best means
of avoiding the spread of MRSA skin infections among team members.
Maintaining good hygiene and
avoiding contact with draining skin Routine culture of all potentially infected wounds.
lesions of other players is the best
means of preventing infection. All Players should be instructed on the importance of proper wound
persons involved with competitive care and have skin lesions covered before play.
sports teams including players,
coaches, parents, and team adminis- Casual use of antibiotics should be discouraged.
trators should be familiarized with
the signs and symptoms of sports- Prompt medical staff notification of suspicious lesions should be
related staphylococcal skin infections encouraged whenever a S. aureus skin infection is suspected.
and be aware of preventive measures
(Table 1). taught proper first aid and encourage appropriate antibiotics based upon
good hygiene among players. A culture and sensitivity results and
Team administrators should be reproducible system understood avoid the indiscriminate use of antibi-
encouraged to provide adequate by all medical care providers and otics for upper respiratory symptoms.
facilities and equipment necessary coaches must be instituted to ensure The misguided administration of
to promote good hygiene. Cleaning proper wound care and coverage antibiotics in the treatment of viral
practice surfaces, whirlpools, saunas, of skin lesions when they occur. illness may contribute to the develop-
training tables, and weight room Medical personnel must emphasize ment of bacterial resistance (Table 2).
equipment should be routinely to players and coaches that players Environmental cultures should not be
performed with an antimicrobial will not be allowed to compete while routinely obtained except by trained
agent effective against a variety they are potentially contagious. epidemiologists in the case of a team-
of bacterial and viral pathogens. wide outbreak, as these cultures are
Coaches and parents should be Players should be encouraged to difficult to accurately obtain and often
practice inform the team’s medical offer little in the way of infection
staff and coaches about active skin control. For those teams with players
infections when they occur. Those who have documented infection,
players with established infection showering with Hibiclens (chlorhexi-
should avoid close physical contact dine) can be an effective means to
with teammates, family members, prevent further spread by reducing
or friends. the carriage rate among asympto-
matic individuals.
Team physicians should culture
all suspicious skin wounds, administer

METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS 128
   123   124   125   126   127   128   129   130   131   132   133