Bacterial Infections

Bacterial infections are common in sports, and treatment is similar for both athletes and nonathletes. Bacterial infections of the skin generally manifest as furuncles, carbuncles, impetigo, cellulitis, or erysipelas. Staphylococcal and streptococ-cal infections are most common, but community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), first reported in the late 1990s, has become a significant problem in athletic training facilities (Lindenmighter et al., 1998; Nguyen et al., 2005).

Sports activities provide a favorable environment for the acquisition and spread of bacterial skin infection. Abrasive surfaces such as artificial turf can harbor bacteria and become a source of infection. Shared equipment, improperly laundered practice gear, person-to-person contact, and inadequate showering facilities without antibacterial soap have all been implicated in the spread of bacterial skin infections in athletes.

Controlling infection in athletes involves prevention, good surveillance, and prompt, appropriate treatment. Shared equipment requires regular cleaning with antibacterial disinfectant. Athletes should shower with antibacterial soap after practice and competition. Abrasions should be addressed expeditiously, scrubbed with antibacterial wash, and covered with sterile dressings, which are changed regularly. Athletes must be instructed to report suspected infections as soon as identified. Topical antibiotics are appropriate for mild infections, with oral or IV antibiotics required for more severe infections. Any significant abscess should have incision and drainage with bacterial culture, including MRSA. Thus far, most CA-MRSA infections in athletes have shown sensitivity to trimethoprim-sulfa-methoxazole, with some isolates sensitive to macrolides and quinolones (Arnold and Wojda, 2005). The resistance patterns are susceptible to rapid change, however, making routine culture of these wounds essential. Athletes with recurrent MRSA infections should be assessed by nasal culture for colonization with MRSA and treated with topical mupirocin ointment if positive.

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