A Clone of Methicillin-Resistant Staphylococcus aureus among Professional Football Players.
Kazakova, Sophia V.; Hageman, Jeffrey C.; Matava, Matthew; Srinivasan, Arjun; Phelan, Larry; Garfinkel, Bernard; Boo, Thomas; McAllister, Sigrid; Anderson, Jim; Jensen, Bette; Dodson, Doug; Lonsway, David; McDougal, Linda K.; Arduino, Matthew; Fraser, Victoria J.; Killgore, George; Tenover, Fred C.; Cody, Sara; Jernigan, Daniel B.
[Article]
New England Journal of Medicine.
352(5):468-475, February 3, 2005.
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Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of infections outside of health care settings. We investigated an outbreak of abscesses due to MRSA among members of a professional football team and examined the transmission and microbiologic characteristics of the outbreak strain.
Methods: We conducted a retrospective cohort study and nasal-swab survey of 84 St. Louis Rams football players and staff members. S. aureus recovered from wound, nasal, and environmental cultures was analyzed by means of pulsed-field gel electrophoresis (PFGE) and typing for resistance and toxin genes. MRSA from the team was compared with other community isolates and hospital isolates.
Results: During the 2003 football season, eight MRSA infections occurred among 5 of the 58 Rams players (9 percent); all of the infections developed at turf-abrasion sites. MRSA infection was significantly associated with the lineman or linebacker position and a higher body-mass index. No MRSA was found in nasal or environmental samples; however, methicillin-susceptible S. aureus was recovered from whirlpools and taping gel and from 35 of the 84 nasal swabs from players and staff members (42 percent). MRSA from a competing football team and from other community clusters and sporadic cases had PFGE patterns that were indistinguishable from those of the Rams' MRSA; all carried the gene for Panton-Valentine leukocidin and the gene complex for staphylococcal-cassette-chromosome mec type IVa resistance (clone USA300-0114).
Conclusions: We describe a highly conserved, community-associated MRSA clone that caused abscesses among professional football players and that was indistinguishable from isolates from various other regions of the United States.
N Engl J Med 2005;352: 468-75.
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