A recent New York Times story called MRSA infections a “hidden foe” in sports and chronicled the many measures top college sports programs and professional franchises have taken over the years to rid their facilities of highly infectious bacteria. In extreme cases, the infections have ended professional sports careers and even proved fatal, the Times reported.  

Most high school and middle school sports budgets don’t allow for the purchase of a $14,000 machine that uses ozone gas to disinfect gear, like that of New York’s Colgate University mentioned in the article. But locker room hygiene is still important at every level of competition, said Dr. Chris Christakos, a family and sports medicine physician at Novant Health Salem Family Medicine in Winston-Salem, North Carolina. While Christakos said MRSA has been rare in the North Carolina schools he’s been around firsthand, he was able to shed some light in the following Q&A on what schools can do to reduce the spread of all infections among student-athletes.   

Q. What is MRSA (methicillin-resistant Staphylococcus aureus)? How does it relate to the term “staph infection,” because both pop up a good bit in news headlines?

A. Staph aureus is a natural bacteria that lives on the skin. We all have natural bacteria on the skin that usually do not cause us any problems. The problem is when you get a nick in your skin and the bacteria multiplies. The big deal with MRSA is it can be resistant to antibiotics, including penicillin, which are our go-to treatment plan for staph infections. That’s why MSRA, a type of staph bacteria, is very difficult to eradicate. Any time you have a break in the skin, you’re at risk to get MRSA there, and it is contagious.   

Q. Have you had any first-hand experiences with MRSA and high school athletes?   

A. I’ve seen just one MRSA case in a high school athlete and that was 15 years ago. It was a football player who was playing on artificial turf. We put him in the hospital and put him on IV antibiotics. At that time, we had rarely seen MRSA outside a hospital setting (although we see it more frequently now in the office, just not necessarily with athletes). It’s more common with professional athletes, especially those playing on a synthetic turf which could actually harbor it. As far as skin infections that we see in schools, we worry more about herpes gladiatorum (“mat herpes”), which you can see during wrestling season because it can spread like wildfire among athletes and shut down their whole season.   

Q. Novant Health partnered recently with Davidson County Schools to place athletic trainers at all seven high schools and to provide physicians for free sports physicals. What are some things that the Novant Health team suggests for those locker rooms?   

A. We always do skin inspections when we do physicals as well. And if kids have open wounds, then they have to be covered. With the trainers and everybody that’s on-site, someone is in charge of doing the laundry. I think good hygiene is the best preventive thing for skin infections.   

Q. Have sports locker rooms changed over the years from what you’ve noticed? Are schools generally being aggressive in how they work to prevent infections?   

A. I think we’re so fortunate now to have certified athletic trainers in the schools who, in some cases, are better trained for certain situations than first responders, and that’s not a slight on first responders. But this is what certified athletic trainers are trained to do. They’re more attuned to hygiene and preventive type measures.   

Q. Is football particularly tricky in terms of MRSA because of the number of players and the amount of equipment used? Or is this a pretty big concern for all sports?   

A. There’s aren’t a lot of other sports with that that much equipment or that many kids on the team. Cross country has maybe that many kids but doesn’t have much equipment.   

If there were other sports I’d be worried about, it would be wrestling and lacrosse. Wrestling because of skin-to-skin contact and lacrosse because it’s a contact sport. They’re wearing pads and there’s a lot of potential for scrapes.   

Q. Are there questions parents of high school and middle school athletes should be asking coaches and administrators when it comes to the potential for MRSA?   

A. The can ask, what’s the hygiene of the locker room? And what is being done to ensure the safety of the kids?’   

Here are three basic steps from the Centers for Disease Control and Prevention (CDC) for what athletes should do in addition to practicing good hygiene:      

  • --Keep your hands clean by washing often with soap and water or using alcohol-based hand sanitizer.

 -- Shower immediately after exercise, and do not share bar soap or towels.

   -- Wash your uniform and clothing after each use. Follow the clothing label’s instructions for washing and drying. Drying clothes completely in a dryer is preferred.

The CDC also has guidelines for cleaning and disinfecting athletic facilities for MRSA.