MRSA — The New Threat to the Health of Your Patrons

April 07, 2011

John Lentz
Director, Office of Recreational Sports
Indiana State University

Methicillin-Resistant Staphylococcus Aureus — remember it, recognize it, respect it. MRSA (“mersa”), as it is commonly known, might be recognizable to the reader as the nasty bug that has been the serious concern of hospital patients and administrators for the past couple of years. It is a particular staph infection that is resistant to typical antibiotics. To those who are already ill and hospitalized, it can even become deadly. So what does this infectious disease have to do with the recreational sports field?

The most effective method of describing the implications of MRSA is by relating a case that the author experienced recently at his university. The athletic training department contacted the Office of Recreational Sports one day and asked if they could move the strength and training program to the recreational facilities for a couple of days. It seems that a couple of athletes were experiencing symptoms of MRSA. While the athletes’ test results were being anticipated, the athletic weight facility was being tested and disinfected. The recreational sports administrators were concerned that the infection might spread from the athletes that would use the recreational weight training facilities. Calls were made to the university’s health center staff, who, after recommending personal hygiene measures, approved of the temporary move. A couple of days later it was discovered that there had been no communications with residential life, various officials within the Division of Student Affairs, nor public affairs. It became apparent that there was no action plan in place relating to this type of infectious disease and little knowledge of the necessary chain of communication, nor implications beyond the athletes themselves. This article will give the reader a brief overview of the implications of this bacterial infection, preventative steps, educational goals, behavioral expectations and response action plans.

MSRA: What is it?

CA-MRSA Bacterial Infection
According to the Centers for Disease Control and Prevention (CDC) MRSA is categorized in two specific formats: “MRSA” relating to the healthcare setting and “CA-MRSA” as community-associated. We will be discussing the implications of the latter. Recently, CA-MRSA has become a concern in the athletic and recreation industry. As with any staph infection, skin contact with the bacteria can result in infection. Although 1/3 of all people carry around various staph on their skin daily , they do not cause infection unless they enter through an open wound or break in the skin. Once the MRSA bacteria have entered the body, the infection can grow rapidly with blood poisoning (sepsis) as a distinctly dangerous possibility without quick medical attention. Cases have occurred where a victim has been hospitalized in the morning with flu-like symptoms and died the same evening.
– Visible symptoms may include a simple blister, pimple, boil, redness or swelling. The sore may resemble a spider bite and may, or may not, be pus-filled.
– Muscle pain with low-grade fever.
– Flu-like symptoms.
– Quickly advancing stages include dangerously high fever.

MRSA: Prevention and Education

Preventative Steps
The following steps are key to preventing MRSA. It is important to note that these procedures are routinely followed by recreational sports and/or athletic programs that are intentional in their approach to facility management and program hygiene standards.

Institutional Steps
– Provide daily cleaning of equipment with appropriate disinfectant concentrating on benches, body supports, all handgrip areas and mats.
– Provide disinfectant spray bottles and wipes for participants to wipe equipment down after personal use.
– Provide apparel policies banning cut-off t-shirts, tank tops, and uncovered sports bras. Although there is no scientific finding supporting that covering one’s arms and torso will protect from bacterial infections, the policy contributes significantly to the educational goal of good hygiene.
– Use anti-bacterial rated detergents and appropriate water temperatures for institutional laundering of towels and/or intramural uniforms. It is also recommended that the dryer setting be set on “high.”
– Use protective gloves when laundering or disinfecting equipment.

Personal Steps
– Keep hands clean by washing with soap and water or using an alcohol-based cleanser.
– Shower immediately following working out sessions.
– Cover any open skin wounds such as abrasions or cuts with a clean dry bandage.
– Avoid sharing personal items such as towels, soap, combs, razors, weight belts, weightlifting gloves, etc.
– Use a barrier between your skin and shared equipment such as clothing or towel.
– Wipe surfaces of equipment before and after use.
– Thoroughly wash any open wound with soap and water and cover with a dressing.
– Get prompt medical attention for any blister, boil, redness, or swelling.
– Alert any team officials such as trainers and/or coaches regarding such wounds.
– Launder work-out clothing and towels regularly in hot water.

Educational Goals
Because MRSA infections in the recreational setting are predominantly due to a lack of hygiene and concern over abrasions, a strong educational component should be undertaken. The following components should be included.
– Flyers and posters placed strategically in the recreation facilities such as locker rooms, restrooms, work-out stations.
– Educational FAQ’s on department websites, newsletters, and information sheets at various venues.
– Articles in student newspaper publications.
– Strongly encourage showers.

Interestingly enough, the student culture has changed dramatically over the years in which it has been demonstrated that students tend to wait to shower at the end of the day. It is normal for students to sit in a classroom after working out for an hour in the Weight Room. Therefore, educational initiatives should stress all forms of hygiene as necessary habits.

MRSA: University Response Plan

Due to the serious nature of MRSA and its likely ability to spread among student populations in a campus setting, appropriate responses are necessary linking many and varied departments in a coordinated fashion when MRSA has been detected on campus. Each university is responsible for setting the protocols that meet each institution’s needs. Below are listed various common departments that should be linked and the responsibilities for each.
– Student Health Center — responsible for taking the lead in providing the appropriate response through medical intervention as well as coordinating the “chain of communication” among linked departments.
– Residential Life — responsible for ensuring the safety of residents who may live with or near an infected individual through educational programming and ensuring good hygiene practices on the residence floor(s).
– Student Affairs — responsible for official university steps and communications inherent to MRSA.
– Public Affairs — responsible for accurate reporting to avoid unfounded rumors and misplaced panic.
– Originating and/or Potentially Affected Department(s) — responsible for ensuring ongoing safe environment, ex.: recreational sports, intercollegiate athletics, sports clubs, fitness classes, etc.

Although MRSA sounds intimidating, with good personal hygiene practices, professionally accepted maintenance standards, sound educational programs and an effective university response, episodes may be kept to a minimum and controlled effectively if encountered.


References/ Resources:
1. Centers for Disease Control and Prevention
“MRSA Info Sheet”,

2. Mecklenburg County Health Department
“Win the Match Against Community-Associated MRSA”

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