CA-MRSA Infection Incidence and Care in High School and Intercollegiate Athletics.

Purpose: Position papers offer solutions to manage community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), yet few studies establish the infection rate, management protocols, and referral practices among student-athletes. Over the 2012-2013 and 2013-2014 school years, we assessed the annual CA-MRSA infection incidence, sport risk, referral practices, and management steps among high school and intercollegiate athletics.

Methods: This study targeted high school and intercollegiate athletic programs in the Northeastern United States. For the 2012-2013 study, 156 athletic trainers completed a one-time questionnaire. In the 2013-2014 study, 87 athletic trainers reported data bimonthly during the academic year. Each questionnaire targeted demographic information, physician-confirmed CA-MRSA infection occurrence, and management of CA-MRSA infections and bacterial skin lesions.

Results: The CA-MRSA infection incidence was 15.5 per 10,000 athletes (95% confidence interval [CI], 13-19) in 2012-2013 and 16.3 per 10,000 athletes (95% CI, 13-21) in 2013-2014. The CA-MRSA infection incidence was higher in wrestling and football compared to the general student-athlete population. During the 2012-2013 study, the wrestling incidence rate was 90.2 per 10,000 (95% CI, 62-132); the football incidence rate was 42.3 per 10,000 (95% CI, 31-59). In the 2013-2014 study, the wrestling incidence rate was 89.0 per 10,000 (95% CI, 50-158); the football incidence rate was 61.4 per 10,000 (95% CI, 42-90). In both studies, primary care and general physicians received over 60% (2012-2013: 60.5%, n = 133; 2013-2014: 66.5%, n = 125) of referrals. In the 2012-2013 study, respondents indicated that student-athlete isolation and setting decontamination were common management steps used (58.1%, n = 306).

Conclusions: The incidence of CA-MRSA infections among student-athletes remains high. Therefore, it is critical that sports medicine providers continually reassess management protocols and best practices.