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Maucotel AL, Kolenda C, Laurent F, Tristan A. Staphylococcus aureus: No ticket for the Paris 2024 Olympic Games! Infect Dis Now 2024; 54:104882. [PMID: 38849255 DOI: 10.1016/j.idnow.2024.104882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 06/09/2024]
Abstract
Athletes are vulnerable to Staphylococcus aureus infections due to skin-to-skin contact and skin abrasions during training and competitions involving sharied sport equipment or toiletries, which promote the spread of the bacteria between athletes and within sport teams. This results not only in higher prevalence of S.aureus carriage among athletes compared to the general population, but also in outbreaks of infections, particularly skin infections, within sports teams. To limit the spread of S. aureus among athletes, a decolonization protocol can be applied when clustered cases of S. aureus infections occur, especially if Panton-Valentine leukocidin-producing strains are implicated. Finally, to avoid exposing athletes to S.aureus transmission/colonization, it is recommended to establish strict and clearly formulated individual and collective hygiene rules and to regularly disinfect shared sports equipment.
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Affiliation(s)
- Anne-Lise Maucotel
- Centre National de Référence des Staphylocoques, Hospices Civils de Lyon, Lyon, France; Laboratoire de Bactériologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard Lyon 1, Lyon, France.
| | - Camille Kolenda
- Centre National de Référence des Staphylocoques, Hospices Civils de Lyon, Lyon, France; Laboratoire de Bactériologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard Lyon 1, Lyon, France.
| | - Frédéric Laurent
- Centre National de Référence des Staphylocoques, Hospices Civils de Lyon, Lyon, France; Laboratoire de Bactériologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard Lyon 1, Lyon, France.
| | - Anne Tristan
- Centre National de Référence des Staphylocoques, Hospices Civils de Lyon, Lyon, France; Laboratoire de Bactériologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard Lyon 1, Lyon, France.
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2
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Smoliga JM. Mpox and Monkeypox Virus: Special Considerations for Athletes in Contact Sports. Sports Med 2023; 53:1301-1313. [PMID: 36848020 PMCID: PMC9969948 DOI: 10.1007/s40279-023-01812-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 03/01/2023]
Abstract
Monkeypox virus infections (mpox) in humans have become increasingly common since the virus was first identified in 1970. Coverage of the ongoing mpox outbreak has emphasized the role of skin-to-skin contact in monkeypox virus transmission and has focused on the community of men who have sex with men. While close contact from sexual activity is currently the main mechanism of monkeypox virus transmission, the potential for contact sports to exacerbate the 2022 outbreak has largely been overlooked. Infectious diseases rapidly spread in sports with significant skin-to-skin contact (i.e., wrestling and other combat sports, American football, and rugby). Mpox has not yet reached the athletic community, but once it does, it may follow a similar pattern of other infectious skin diseases in sports. Thus, it is critical to initiate a discussion of the risk of mpox and potential preventive measures within a sports context. This Current Opinion aims to provide stakeholders within the sports community with a brief review of infectious skin diseases in athletes, an overview of mpox and why it is relevant to athletes, and recommendations to reduce the risk of monkeypox virus transmission within sports settings. Guidelines for sports participation in athletes exposed to mpox and those with suspected, probable, and confirmed cases of monkeypox are provided.
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Affiliation(s)
- James M Smoliga
- Department of Physical Therapy, High Point University, One University Parkway, High Point, NC, 27268, USA.
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3
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Breed MW, Perez HL, Otto M, Villaruz AE, Weese JS, Alvord GW, Donohue DE, Washington F, Kramer JA. Bacterial Genotype, Carrier Risk Factors, and an Antimicrobial Stewardship Approach Relevant to Methicillin-resistant Staphylococcus aureus Prevalence in a Population of Macaques Housed in a Research Facility. Comp Med 2023; 73:134-144. [PMID: 36941053 PMCID: PMC10162382 DOI: 10.30802/aalas-cm-22-000018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/31/2022] [Accepted: 10/27/2022] [Indexed: 03/22/2023]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) remains a significant problem for human and animal health and can negatively affect the health status of macaques and other nonhuman primates (NHP) in research colonies. However, few publications provide guidance on the prevalence, genotype, or risk factors for macaques with MRSA and even fewer on how to effectively respond to MRSA once identified in a population. After having a clinical case of MRSA in a rhesus macaque, we sought to determine the MRSA carrier prevalence, risk factors, and genotypes of MRSA in a population of research NHPs. Over a 6-wk period in 2015, we collected nasal swabs from 298 NHPs. MRSA was isolated from 28% (n = 83). We then reviewed each macaque's medical record for a variety of variables including animal housing room, sex, age, number of antibiotic courses, number of surgical interventions, and SIV status. Analysis of these data suggests that MRSA carriage is associated with the room location, age of the animal, SIV status, and the number of antibiotic courses. We used multilocus sequence typing and spa typing on a subset of MRSA and MSSA isolates to determine whether the MRSA present in NHPs was comparable with common human strains. Two MRSA sequence types were predominant: ST188 and a novel MRSA genotype, neither of which is a common human isolate in the United States. We subsequently implemented antimicrobial stewardship practices (significantly reducing antimicrobial use) and then resampled the colony in 2018 and found that MRSA carriage had fallen to 9% (26/285). These data suggest that, as in humans, macaques may have a high carrier status of MRSA despite low clinically apparent disease. Implementing strategic antimicrobial stewardship practices resulted in a marked reduction in MRSA carriage in the NHP colony, highlighting the importance of limiting antimicrobial use when possible.
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Affiliation(s)
- Matthew W Breed
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Bethesda, Maryland
| | | | - Michael Otto
- Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Amer E Villaruz
- Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - J Scott Weese
- Centre for Public Health and Zoonoses, Department of Pathobiology, University of Guelph, Guelph, Ontario, Canada
| | - Gregory W Alvord
- Statistical Consulting, Data Management Services, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland; and
| | - Duncan E Donohue
- Statistical Consulting, Data Management Services, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland; and
| | | | - Joshua A Kramer
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Bethesda, Maryland
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4
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Almasri D, Noor A, Diri R. Behavioral Changes in Gym Attending Due to COVID-19 Pandemic: A Descriptive Survey. J Microsc Ultrastruct 2021; 8:165-167. [PMID: 33623742 PMCID: PMC7883492 DOI: 10.4103/jmau.jmau_64_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 07/11/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction: On the declaration of the COVID-19 pandemic lockdown clearance in Saudi Arabia, the high-profile precautions were applied as a major step to resume the normal life activities and to coexist with the pandemic. One of those resumed activities is the reopening of the gym and fitness centers. The perception and the commitment with safe precautions in terms of personal hygiene and sterilization have dramatically changed due to the COVID-19 pandemic. The purpose of this study was to assess the behavior of gym attendees toward preventive precautions prior to the pandemic and the behavioral changes that will be accommodated after the new policy and procedure of attending a gym and fitness centers. Methods: A cross-sectional descriptive study was conducted in February 2020, a 1 month prior to the complete lockdown announcement in Saudi Arabia as a result of the COVID-19 pandemic outbreak. An electronic questionnaire was provided during a personal interview with gym and fitness centers' participants. Results: The majority of participants never use sterile wipes or any sterile product before or after using gym equipment (61.6%), and 35.4% of gym attendants do not use any sterilization materials distributed through fitness centers. In addition, most of the participants have had an episode of skin infections or respiratory infection at the fitness center for the past 12 months (22.2%), whereas 80.8% do not know about tinea microbial that causes athlete's foot, and 65.7% of them utilize the shower in the gym after their workout. Conclusion: The lack of awareness of previous and new gym members regarding safety precautions during indoor exercise should be overcome by more future educational intervention and emphasizing on following the Ministry of Sports in Saudi Arabia, even after the complete clearance of COVID-19 pandemic.
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Affiliation(s)
- Diena Almasri
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmad Noor
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Reem Diri
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
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5
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Mason MR, Morawski BM, Bayliss RL, Noor FM, Jama SH, Clabots CL, Johnson JR. Prevalence, Characteristics, and Epidemiology of Microbial Hand Contamination Among Minnesota State Fair Attendees (2014). Front Public Health 2020; 8:574444. [PMID: 33392128 PMCID: PMC7772179 DOI: 10.3389/fpubh.2020.574444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/20/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Many antimicrobial-resistant infections are community-acquired, yet community carriage of microorganisms by healthy individuals is poorly characterized. We assessed microorganism carriage on the hands of Minnesota State Fair attendees and explored associated factors. Methods: Minnesota State Fair attendees (in 2014) from households with ≥2 members (≥1 member being <19 years old [a child]) were eligible to participate. Participants provided biological samples via a hand plating technique and completed a questionnaire on factors potentially related to microorganism carriage. Using presumptive taxonomic identifications and disk-diffusion-determined resistance phenotypes, hand-culture isolates were classified by microbial type; types were grouped into four broad categories based on inferred pathogenicity and consistency with the skin microbiota. Descriptive statistics, X2 tests, and generalized linear mixed-effects models were used to explore associations between survey and culture data. Results: We enrolled 206 participants from 82 households during 2 days; 50% of subjects were children. Overall, 99.5% (205/206) of hand samples yielded microorganisms. Most were non-pathogenic, whether skin microbiota (98.5% of participants) or non-skin microbiota (93.2% of participants). Only 2.4% (5/206) of samples yielded antibiotic-resistant bacteria. Children were more likely than adults to carry potentially pathogenic (OR = 3.63, 95% CI: 1.66–7.93) and presumably non-pathogenic (OR = 6.61, 95% CI: 1.67–26.15) non-skin microorganisms. Conclusions: Large community gatherings can serve as efficient sites for estimating the prevalence of microorganism carriage. A small proportion of participants carried antimicrobial-resistant pathogens on their hands; most carried non-pathogenic microorganisms, and no exposures specific to the state fair were associated with microorganism carriage.
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Affiliation(s)
- Meghan R Mason
- Public Health Department, Henrietta Schmoll School of Health, Saint Catherine University, Saint Paul, MN, United States.,Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Bozena M Morawski
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Ruby L Bayliss
- Public Health Department, Henrietta Schmoll School of Health, Saint Catherine University, Saint Paul, MN, United States
| | - Fatuma M Noor
- Public Health Department, Henrietta Schmoll School of Health, Saint Catherine University, Saint Paul, MN, United States
| | - Sagal H Jama
- Public Health Department, Henrietta Schmoll School of Health, Saint Catherine University, Saint Paul, MN, United States
| | - Connie L Clabots
- Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - James R Johnson
- Minneapolis VA Health Care System, Minneapolis, MN, United States.,Division of Infectious Disease and International Medicine, School of Medicine, University of Minnesota, Minneapolis, MN, United States
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6
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Golpanian RS, Abrouk M, Yosipovitch G. Common cutaneous manifestations of CrossFit workouts. J Eur Acad Dermatol Venereol 2020; 34:e730-e732. [PMID: 32348579 DOI: 10.1111/jdv.16549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- R S Golpanian
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M Abrouk
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - G Yosipovitch
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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7
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Debenham L, Reynolds J. Climbing Gyms as Possible High-Risk Transmission Locations in Microbial Outbreaks. Wilderness Environ Med 2020; 31:375-376. [PMID: 32493665 PMCID: PMC7151375 DOI: 10.1016/j.wem.2020.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/20/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Luke Debenham
- Birmingham Medical School, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, England
| | - Jacob Reynolds
- Birmingham Medical School, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, England
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8
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Abstract
There are numerous disorders of the skin that occur in athletes. These include infections, mechanical injury, and inflammatory skin diseases such as dermatitis, urticaria, and others. This paper discusses some of the most common athletic skin diseases.
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Affiliation(s)
- Patrick C Carr
- Department of Dermatology, University of Virginia, PO Box 800718, Charlottesville, VA 22908, USA
| | - Thomas G Cropley
- Department of Dermatology, University of Virginia, PO Box 800718, Charlottesville, VA 22908, USA.
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9
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Valeriani F, Margarucci LM, Gianfranceschi G, Ciccarelli A, Tajani F, Mucci N, Ripani M, Romano Spica V. Artificial-turf surfaces for sport and recreational activities: microbiota analysis and 16S sequencing signature of synthetic vs natural soccer fields. Heliyon 2019; 5:e02334. [PMID: 31517095 PMCID: PMC6728760 DOI: 10.1016/j.heliyon.2019.e02334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/04/2019] [Accepted: 08/15/2019] [Indexed: 12/12/2022] Open
Abstract
Synthetic fibres are used in place of the natural grass worldwide, for realizing playgrounds, soccer fields and even domestic gardens or recreational structures. An intensive use of artificial turf is currently observed in sports facilities, due to lower costs, higher sustainability in recycling of materials, and advantages related to athletic practice and performance. However, even if chemical and physical risks were studied, the microbiological component was not fully addressed, especially considering a comprehensive evaluation of the microbiota in synthetic vs natural playground surfaces. Here, we investigated the microbial community present on soccer fields, using Next Generation Sequencing and a 16S amplicon sequencing approach. Artificial and natural turfs show own ecosystems with different microbial profiles and a mean Shannon's diversity value of 2.176 and 2.475, respectively. The bacterial community is significantly different between facilities (ANOSIM: R = 0.179; p < 0.001) and surface materials (ANOSIM: R = 0.172; p < 0.005). The relative abundance of potentially pathogenic bacterial OTUs was higher in synthetic than in natural samples (ANOVA, F = 2.2). Soccer fields are characterized by their own microbiota, showing a different 16S amplicon sequencing signature between natural and artificial turfs.
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Affiliation(s)
- Federica Valeriani
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Lory Marika Margarucci
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Gianluca Gianfranceschi
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Antonello Ciccarelli
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Filippo Tajani
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Nicolina Mucci
- INAIL, Department of Technological Innovations and Safety of Plants, Products and Anthropic Settlements, Rome, Italy
| | - Maurizio Ripani
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Vincenzo Romano Spica
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
- Corresponding author.
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10
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Mitchell JJ, Jackson JM, Anwar A, Singleton SB. Bacterial Sport-Related Skin and Soft-Tissue Infections (SSTIs): An Ongoing Problem Among a Diverse Range of Athletes. JBJS Rev 2019; 5:01874474-201701000-00002. [PMID: 28135229 DOI: 10.2106/jbjs.rvw.16.00006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Justin J Mitchell
- 1The Steadman Clinic and Steadman Philippon Research Institute, Vail, Colorado2Division of Dermatology, University of Louisville, Louisville, Kentucky3CLn Skin Care, Top MD Skin Care, Dallas, Texas
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11
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Association Between Contact Sports and Colonization with Staphylococcus aureus in a Prospective Cohort of Collegiate Athletes. Sports Med 2018; 47:1011-1019. [PMID: 27577687 DOI: 10.1007/s40279-016-0618-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Athletes have a higher risk of infection with Staphylococcus aureus than the general population. Most studies in athletes have included primarily male contact sports participants and have not assessed S. aureus carriage over time. We aimed to examine the epidemiology and risk factors of S. aureus carriage in a cohort of male and female collegiate athletes. STUDY DESIGN We conducted a prospective cohort study of 377 varsity collegiate athletes from August 2008 to April 2010. A baseline questionnaire ascertained risk factors for colonization. Nasal and oropharyngeal swabs were obtained at enrollment and monthly thereafter to detect S. aureus colonization. The primary outcome was S. aureus colonization, both with methicillin-susceptible and methicillin-resistant S. aureus, as defined by bacterial culture and molecular confirmation. Secondary outcomes were time to colonization with S. aureus and carriage profile, defined as non-carrier, intermittent carrier, or persistent carrier. RESULTS Overall, 224 contact sports and 153 non-contact sports athletes were enrolled. Contact sports athletes had a higher risk of carrying S. aureus over time: They had higher odds of being colonized with MRSA (OR 2.36; 95 % CI 1.13-4.93) and they tended to carry S. aureus for longer periods of time (intermittent carriage OR 3.60; 95 % CI 2.02-6.40; persistent carriage OR 2.39; 95 % CI 1.21-4.72). Athletes engaged in contact sports also acquired S. aureus more quickly (HR 1.61; 95 % CI 1.02-2.55). CONCLUSIONS Staphylococcus aureus carriage was common in contact sports athletes. These findings suggest that efforts to prevent transmission of S. aureus among athletes should be focused on contact sports teams.
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12
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Ibrahim Z, Petrusan AJ, Hooke P, Hinsa-Leasure SM. Reduction of bacterial burden by copper alloys on high-touch athletic center surfaces. Am J Infect Control 2018; 46:197-201. [PMID: 29102052 DOI: 10.1016/j.ajic.2017.08.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/23/2017] [Accepted: 08/23/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Athletic centers have been locations for the transmission of community-acquired infections. This study assessed the capacity of copper alloys to reduce the bacterial burden associated with high-touch athletic center equipment. Copper alloy weights and grips were rotated with rubber coated and stainless steel controls in an undergraduate college athletic center over a 16-month period. The athletic center is used by college athletic teams, student body, and local community. METHODS The primary outcome was to compare bacterial burdens on copper and control grips by swabbing surfaces. Significance was determined using the nonparametric Mann-Whitney U test with significance assessed at P < .05. Secondary outcomes included characterizing bacterial communities on surfaces and conducting antibiotic susceptibility testing using the Kirby-Bauer disk diffusion method. RESULTS Control athletic center components carried bacterial loads 94% larger than those found on copper alloy components. Bacterial community characterization revealed Staphylococcus to be the most common bacterial genus found on grip surfaces. Antibiotic resistance testing of the Staphylococcus isolates revealed that all isolates were susceptible to vancomycin and linezolid, whereas 35% of copper alloy isolates and 44% of control isolates were resistant to erythromycin. CONCLUSIONS Copper alloys can mitigate the bacterial burden on high-touch surfaces. Strategically placing copper alloys in areas of high human contact can augment infection control efforts and potentially decrease community-acquired infections in athletic centers.
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Affiliation(s)
- Zina Ibrahim
- Department of Biology, Grinnell College, Grinnell, IA
| | | | - Patrick Hooke
- Department of Biology, Grinnell College, Grinnell, IA
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13
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Couvé-Deacon E, Postil D, Barraud O, Duchiron C, Chainier D, Labrunie A, Pestourie N, Preux PM, François B, Ploy MC. Staphylococcus Aureus Carriage in French Athletes at Risk of CA-MRSA Infection: a Prospective, Cross-sectional Study. SPORTS MEDICINE-OPEN 2017; 3:28. [PMID: 28815486 PMCID: PMC5559403 DOI: 10.1186/s40798-017-0094-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/18/2017] [Indexed: 11/10/2022]
Abstract
Background Staphylococcus aureus (SA) is a leading cause of infectious diseases in sports teams. In recent decades, community-associated SA (CA-SA) strains have emerged worldwide and have been responsible for outbreaks in sports teams. There are very few data on the prevalence of these strains in France, and none on the carriage among athletes. Methods We conducted a cross-sectional study to determine the SA carriage proportion among athletes practicing sports at risk for CA-SA infection in a French county, and determined the methicillin-resistant and/or CA-SA proportion. We also analyzed SA carriage according to risks factors and studied the SA clonality in a sample of our population. Results We included 300 athletes; SA carriage proportion was 61% (n = 183) and one was MRSA carrier (0.33%). The MRSA strain belonged to the clonal complex ST5. None of the strain produced Panton Valentine Leucocidin, and we did not find clonal distribution within the teams. Interestingly, we found a high throat-only carriage (n = 57), 31.1% of the SA carriers. Conclusion We found a high SA carriage with a local epidemiology quite different than that reported in a similar population in the USA. Further studies on SA carriage should include throat sampling. Trial registration The approved protocol was registered on ClinicalTrial.gov, NCT01148485.
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Affiliation(s)
- E Couvé-Deacon
- University Limoges, UMR, 1092, Limoges, France.,INSERM, UMR, 1092, Limoges, France.,CHU Limoges, Laboratory of Bacteriology-Virology-Hygiene, 2 avenue Martin Luther King, 87042, Limoges, cedex, France
| | - D Postil
- INSERM, CIC-1435, F-87000, Limoges, France
| | - O Barraud
- University Limoges, UMR, 1092, Limoges, France.,INSERM, UMR, 1092, Limoges, France.,CHU Limoges, Laboratory of Bacteriology-Virology-Hygiene, 2 avenue Martin Luther King, 87042, Limoges, cedex, France
| | - C Duchiron
- INSERM, CIC-1435, F-87000, Limoges, France
| | - D Chainier
- University Limoges, UMR, 1092, Limoges, France.,INSERM, UMR, 1092, Limoges, France.,CHU Limoges, Laboratory of Bacteriology-Virology-Hygiene, 2 avenue Martin Luther King, 87042, Limoges, cedex, France
| | - A Labrunie
- CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
| | - N Pestourie
- CHU Limoges, Laboratory of Bacteriology-Virology-Hygiene, 2 avenue Martin Luther King, 87042, Limoges, cedex, France
| | - P M Preux
- CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
| | - B François
- University Limoges, UMR, 1092, Limoges, France.,INSERM, UMR, 1092, Limoges, France.,INSERM, CIC-1435, F-87000, Limoges, France
| | - M C Ploy
- University Limoges, UMR, 1092, Limoges, France. .,INSERM, UMR, 1092, Limoges, France. .,CHU Limoges, Laboratory of Bacteriology-Virology-Hygiene, 2 avenue Martin Luther King, 87042, Limoges, cedex, France.
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14
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Chen BJ, Xie XY, Ni LJ, Dai XL, Lu Y, Wu XQ, Li HY, Yao YD, Huang SY. Factors associated with Staphylococcus aureus nasal carriage and molecular characteristics among the general population at a Medical College Campus in Guangzhou, South China. Ann Clin Microbiol Antimicrob 2017; 16:28. [PMID: 28399856 PMCID: PMC5387264 DOI: 10.1186/s12941-017-0206-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 04/06/2017] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The nasal cavity is the main colonization site of Staphylococcus aureus (S. aureus) in human body. Nasal carriage may be a strong risk factor for some serious infection. There was still limited information about the nasal carriage for S. aureus in south China. METHODS Sought to determine the prevalence and molecular characteristics of S. aureus nasal carriage, 295 volunteers residing on a medicine campus were investigated and sampled the nasal cavity swab. Selected S. aureus isolates were carried through molecular analysis, including pulsed-field gel electrophoresis (PFGE), multilocus sequence analysis, staphylococcal cassette chromosome mec (SCCmec) and virulence gene detection. RESULTS A total of 73 S. aureus isolates were recovered from separate subjects (24.7%, 73/295), with one methicillin-resistant S. aureus (MRSA) isolate (0.3%, 1/295). Among the 73 isolates, 71 isolates were successfully grouped into 13 pulsotypes by PFGE analysis, with profiles A and L the most prevalent; 12 sequence types (STs) were found among the 23 isolates which had similar drug resistant spectrum. ST59, ST188 and ST1 were the most prevalent, accounting for 17.4, 13.0 and 13.0% of all isolates, respectively. The MRSA isolate presented ST8-SCCmec III. 56.5% of isolates carried both the staphylococcal enterotoxin A (sea) and enterotoxin B (seb) genes. 83.6% of the S. aureus isolates were resistant to penicillin, all isolates were susceptible to quinupristin/dalfopristin, levofloxacin, teicoplanin and vancomycin. The most common risk factors for S. aureus carriage were being male, age ≤30 years, and nasal cavity cleaning habits. CONCLUSIONS Colonization by S. aureus was greater among male and young age (20-30 years) students and those with irregularity nasal cleaning. The S. aureus isolates selected were revealed into various sequence types and pulsotypes, indicating molecular heterogeneity among S. aureus isolates from the populations in the medical college in Guangzhou.
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Affiliation(s)
- B J Chen
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - X Y Xie
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - L J Ni
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - X L Dai
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Y Lu
- Cross Infection Control Office, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, Guangdong, China
| | - X Q Wu
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - H Y Li
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Y D Yao
- Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, Guangdong, China.
| | - S Y Huang
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
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Mukherjee N, Sulaiman IM, Banerjee P. Characterization of methicillin-resistant Staphylococcus aureus isolates from fitness centers in the Memphis metropolitan area, Tennessee. Am J Infect Control 2016; 44:1681-1683. [PMID: 27658767 DOI: 10.1016/j.ajic.2016.06.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 06/28/2016] [Accepted: 06/28/2016] [Indexed: 11/19/2022]
Abstract
Indoor skin-contact surfaces of public fitness centers may serve as reservoirs of potential human transmission of methicillin-resistant Staphylococcus aureus (MRSA). We found a high prevalence of multidrug-resistant (MDR) MRSA of clonal complex 59 lineage harboring a variety of extracellular toxin genes from surface swab samples collected from inanimate surfaces of fitness centers in the Memphis metropolitan area, Tennessee. Our findings underscore the role of inanimate surfaces as potential sources of transmission of MDR MRSA strains with considerable genetic diversity.
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Affiliation(s)
- Nabanita Mukherjee
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, TN
| | - Irshad M Sulaiman
- Southeast Regional Laboratory, Microbiological Sciences Branch, U.S. Food and Drug Administration, Atlanta, GA
| | - Pratik Banerjee
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, TN.
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Couvé-Deacon E, Tristan A, Pestourie N, Faure C, Doffoel-Hantz V, Garnier F, Laurent F, Lina G, Ploy MC. Outbreak of Panton-Valentine Leukocidin-Associated Methicillin-Susceptible Staphylococcus aureus Infection in a Rugby Team, France, 2010-2011. Emerg Infect Dis 2016; 22:96-9. [PMID: 26690308 PMCID: PMC4696688 DOI: 10.3201/eid2201.150597] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Staphylococcus aureus strains that produce Panton-Valentine leukocidin are known to cause community infections. We describe an outbreak of skin abscesses caused by Panton-Valentine leukocidin-producing methicillin-susceptible S. aureus (clonal complex 121) in a professional rugby team in France during July 2010-February 2011. Eight team members were carriers; 7 had skin abscesses.
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Abstract
Although the medical complications of sports are usually traumatic in nature, infectious hazards also arise. While blood-borne pathogens such as HIV, hepatitis B, and hepatitis C, cause significant illness, the risk of acquiring these agents during sporting activities is minimal. Skin infections are more commonplace, arising from a variety of microbial agents including bacterial, fungal, and viral pathogens. Sports involving water contact can lead to enteric infections, eye infections, or disseminated infections such as leptospirosis. Mumps, measles, and influenza are vaccine-preventable diseases that have been transmitted during sporting events, both in players and in spectators. Prevention is the key to many of these infections. Players should be vaccinated and should not participate in sports if their infection can be spread by contact, airborne, or droplet transmission.
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Urban J, Fergus DJ, Savage AM, Ehlers M, Menninger HL, Dunn RR, Horvath JE. The effect of habitual and experimental antiperspirant and deodorant product use on the armpit microbiome. PeerJ 2016; 4:e1605. [PMID: 26855863 PMCID: PMC4741080 DOI: 10.7717/peerj.1605] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 12/27/2015] [Indexed: 12/19/2022] Open
Abstract
An ever expanding body of research investigates the human microbiome in general and the skin microbiome in particular. Microbiomes vary greatly from individual to individual. Understanding the factors that account for this variation, however, has proven challenging, with many studies able to account statistically for just a small proportion of the inter-individual variation in the abundance, species richness or composition of bacteria. The human armpit has long been noted to host a high biomass bacterial community, and recent studies have highlighted substantial inter-individual variation in armpit bacteria, even relative to variation among individuals for other body habitats. One obvious potential explanation for this variation has to do with the use of personal hygiene products, particularly deodorants and antiperspirants. Here we experimentally manipulate product use to examine the abundance, species richness, and composition of bacterial communities that recolonize the armpits of people with different product use habits. In doing so, we find that when deodorant and antiperspirant use were stopped, culturable bacterial density increased and approached that found on individuals who regularly do not use any product. In addition, when antiperspirants were subsequently applied, bacterial density dramatically declined. These culture-based results are in line with sequence-based comparisons of the effects of long-term product use on bacterial species richness and composition. Sequence-based analyses suggested that individuals who habitually use antiperspirant tended to have a greater richness of bacterial OTUs in their armpits than those who use deodorant. In addition, individuals who used antiperspirants or deodorants long-term, but who stopped using product for two or more days as part of this study, had armpit communities dominated by Staphylococcaceae, whereas those of individuals in our study who habitually used no products were dominated by Corynebacterium. Collectively these results suggest a strong effect of product use on the bacterial composition of armpits. Although stopping the use of deodorant and antiperspirant similarly favors presence of Staphylococcaceae over Corynebacterium, their differential modes of action exert strikingly different effects on the richness of other bacteria living in armpit communities.
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Affiliation(s)
- Julie Urban
- North Carolina Museum of Natural Sciences , Raleigh, NC , USA
| | - Daniel J Fergus
- North Carolina Museum of Natural Sciences , Raleigh, NC , USA
| | - Amy M Savage
- Department of Biology & Center for Computational & Integrative Biology, Rutgers, The State University of New Jersey-Camden , Camden, NJ , USA
| | - Megan Ehlers
- North Carolina Museum of Natural Sciences, Raleigh, NC, USA; Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Holly L Menninger
- Department of Biological Sciences, North Carolina State University , Raleigh, NC , USA
| | - Robert R Dunn
- Department of Applied Ecology and Keck Center for Behavioral Biology, North Carolina State University, Raleigh, NC, USA; Center for Macroecology, Evolution and Climate, Natural History Museum of Denmark, University of Copenhagen, Copenhagen, Denmark
| | - Julie E Horvath
- North Carolina Museum of Natural Sciences, Raleigh, NC, USA; Department of Biological and Biomedical Sciences, North Carolina Central University, Durham, NC, USA; Department of Evolutionary Anthropology, Duke University, Durham, NC, USA
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Kahanov L, Kim YK, Eberman L, Dannelly K, Kaur H, Ramalinga A. Staphylococcus aureus and community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in and around therapeutic whirlpools in college athletic training rooms. J Athl Train 2015; 50:432-7. [PMID: 25710853 DOI: 10.4085/1062-6050-49.3.96] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has become a leading cause of skin and soft tissue infection in the nonhospitalized community. Care of the athletes in athletic training rooms is specifically designed with equipment tailored to the health care needs of the athletes, yet recent studies indicate that CA-MRSA is still prevalent in athletic facilities and that cleaning methods may not be optimal. OBJECTIVE To investigate the prevalence of Staphylococcus aureus and CA-MRSA in and around whirlpools in the athletic training room. DESIGN Cross-sectional study. SETTING National Collegiate Athletic Association Division I university. PATIENTS OR OTHER PARTICIPANTS Student-athletes (n = 109) consisting of 46 men (42%) and 63 women (58%) representing 6 sports. MAIN OUTCOME MEASURE(S) Presence of MRSA and Staphylococcus aureus in and around the whirlpool structures relative to sport and number of athletes using the whirlpools. RESULTS We identified Staphylococcus aureus in 22% (n = 52/240) of the samples and MRSA in 0.8% (n = 2/240). A statistically significant difference existed between the number of athletes using the whirlpool and the presence of Staphylococcus aureus in and around the whirlpools (F(2,238) = 2.445, P = .007). However, Staphylococcus aureus was identified regardless of whether multiple athletes used a whirlpool or no athletes used a whirlpool. We did not identify a relationship between the number of athletes who used a whirlpool and Staphylococcus aureus or MRSA density (P = .134). CONCLUSIONS Staphylococcus aureus and MRSA were identified in and around the whirlpools. Transmission of the bacteria can be reduced by following the cleaning and disinfecting protocols recommended by the Centers for Disease Control and Prevention. Athletic trainers should use disinfectants registered by the Environmental Protection Agency to sanitize all whirlpools between uses.
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Affiliation(s)
- Leamor Kahanov
- Indiana State University, Terre Haute. Dr Kahanov is now at College of Health Sciences, Misericordia University, Dallas, PA. Young Kyun Kim, MA, is now at Moungji University, Yong-in, South Korea
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Champion AE, Goodwin TA, Brolinson PG, Werre SR, Prater MR, Inzana TJ. Prevalence and characterization of methicillin-resistant Staphylococcus aureus isolates from healthy university student athletes. Ann Clin Microbiol Antimicrob 2014; 13:33. [PMID: 25085442 PMCID: PMC4362218 DOI: 10.1186/s12941-014-0033-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 07/13/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has been increasing in the general population, and there is concern that close or physical contact, such as in professional and collegiate sports, may increase spread of MRSA. We sought to determine the prevalence of MRSA colonization of male and female athletes from 9 different sports at a major, Division I University during a 12-week period, and determine the USA and SCCmec type from select isolates. METHODS Swabs for culture of MRSA were obtained from nasal, axillary, and inguinal sites from healthy, asymptomatic student athletes and support staff each week for 12 weeks. Select MRSA isolates were typed by pulsed field gel electrophoresis (PFGE), and the genes encoding for MecA, cassette chromosome recombinase (Ccr), and several toxins were determined by multiplex polymerase chain reaction (PCR). Discrepant results were clarified by multi-locus sequence typing (MLST) and spa typing. RESULTS Thirty-five percent (78/223) of test subjects were positive for MRSA during the study period, resulting in isolation of 139 MRSA isolates. However, 47% (37/78) of MRSA-positive participants carried MRSA in axillary or inguinal sites, but not in the anterior nares. There was significant correlation between MRSA carriage and participation in wrestling (76%, 19/25; adjusted odds ratio 29.7, 95% CI 5.8-151.5) and baseball (44%, 17/39; adjusted odds ratio 4.4, 95% CI 1.1- 17.4), compared with a staff prevalence of 18.1% (4/22), but other factors were not examined. Multiplex PCR analysis indicated that of the 32 isolates examined 26 could be typed, and all of these carried the SCCmec type IV cassette. PFGE typing identified USA types 300, 400, 500, 700, and 800. However, one isolate was not a known USA type, but was identified as a novel ST951 by MLST, and as spa type t216. Of the strains typed from the same individual, there was consistency, but also variation and alternation of the SCCmec and spa types isolated from individual subjects. Various staphylococcal toxin genes were identified in 31 of the 32 isolates analyzed. CONCLUSIONS Colonization by MRSA was greater in some student athletes than the average carriage rate for the general population, and only 53% of MRSA carriers were identified by nasal cultures. Carriage of MRSA clones on the same individual and transmission to contacts could vary over time, indicating colonization can be a dynamic process that may be difficult to control.
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Affiliation(s)
- Anna E Champion
- Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA, USA.
| | - Thomas A Goodwin
- Edward Via Virginia College of Osteopathic Medicine, Blacksburg, VA, 24061, USA.
| | - P Gunnar Brolinson
- Edward Via Virginia College of Osteopathic Medicine, Blacksburg, VA, 24061, USA.
| | - Stephen R Werre
- Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA, USA.
| | - M Renee Prater
- Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA, USA. .,Edward Via Virginia College of Osteopathic Medicine, Blacksburg, VA, 24061, USA.
| | - Thomas J Inzana
- Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA, USA. .,Virginia Tech Carilion School of Medicine, Virginia Polytechnic Institute and State University, Life Sciences 1, 970 Washington St. SW, Blacksburg, VA, 24061, USA.
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22
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Zhou YP, Wilder-Smith A, Hsu LY. The role of international travel in the spread of methicillin-resistant Staphylococcus aureus. J Travel Med 2014; 21:272-81. [PMID: 24894491 DOI: 10.1111/jtm.12133] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 02/18/2014] [Accepted: 02/19/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND Increasing international travel has facilitated the transmission of various multidrug-resistant bacteria-including methicillin-resistant Staphylococcus aureus (MRSA)-across continents. Individuals may acquire MRSA from the community, healthcare facilities, or even from animal exposure. Skin contact with colonized individuals, fomites, or animals during an overseas trip may result in either asymptomatic colonization or subsequent clinically significant MRSA disease. MRSA strains that harbor the Panton-Valentine leucocidin toxin are particularly associated with community transmission and may potentially have enhanced virulence resulting in serious skin and soft tissue infections or even necrotizing pneumonia. More importantly, secondary transmission events upon return from traveling have been documented, leading to potentially detrimental outbreaks within the community or the healthcare setting. We sought to review the existing literature relating to the role of various aspects of travel in the spread of MRSA. Risk factors for acquiring MRSA during travel together with the need for targeted screening of high-risk individuals will also be explored. METHODS Data for this article were identified via PubMed searches using a combination of search terms: "methicillin resistance," "MRSA," "livestock-associated MRSA," "community-associated MRSA," "travel," and "outbreak." The relevant articles were extensively perused to determine secondary sources of data. RESULTS AND CONCLUSIONS Our review of the current literature suggests that international travel plays a significant role in the transmission of MRSA, potentially contributing to the replacement of existing endemic MRSA with fitter and more transmissible strains. Therefore, selective and targeted screening of travelers with risk factors for MRSA colonization may be beneficial. Healthcare professionals and patients should be considered for screening if they were to return from endemic areas, with the former group decolonized before returning to patient care work, in order to reduce the transmission of MRSA to vulnerable patient populations.
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Affiliation(s)
- Yvonne P Zhou
- Department of Pharmacy, Singapore General Hospital, Singapore, Singapore
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23
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Bräuer SL, Vuono D, Carmichael MJ, Pepe-Ranney C, Strom A, Rabinowitz E, Buckley DH, Zinder SH. Microbial sequencing analyses suggest the presence of a fecal veneer on indoor climbing wall holds. Curr Microbiol 2014; 69:681-9. [PMID: 24972665 DOI: 10.1007/s00284-014-0643-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 05/06/2014] [Indexed: 01/22/2023]
Abstract
Artificial climbing walls represent a unique indoor environment in which humans interact closely with a variety of surface types. Climbing wall holds may mediate transmission of organisms between individuals, and yet there are no studies that identify microorganisms present on these surfaces. In the current study, the microorganisms found on climbing wall holds were characterized by analysis of amplified SSU rRNA gene sequences. In contrast to many other studies of built environments, the majority of microorganisms on holds were most closely related to microbes annotated as being recovered from environmental sources, such as soil, with human skin also representing an important source. Regional patterns were evident as rRNA gene sequences from the marine cyanobacterium Prochlorococcus were abundant in gyms found within 16 km of the ocean. Enterobacteriaceae were present on 100 % of holds surveyed, and the members detected are commonly associated with fecal matter.
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Affiliation(s)
- S L Bräuer
- Department of Biology, Appalachian State University, Boone, NC, 28608, USA,
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24
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Grant D, Koh TH, Tan YE, Hsu LY, Kurup A, Donahue SK, Mann J, Fisher D. An Outbreak of Community Associated Methicillin Resistant Staphylococcus aureus Subtype USA300 at an International School in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2013. [DOI: 10.47102/annals-acadmedsg.v42n11p575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Community associated methicillin-resistant Staphylococcus aureus (CA-MRSA) subtype USA300 remains relatively well confined within North American shores. Between August and November 2010, a large international school in Singapore recorded 27 skin and soft tissue infections, 8 of which were confirmed USA 300. This study reports the outbreak investigation and the interventions instituted.
Key words: Soft tissue infections (SSTIs), Transmission
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Affiliation(s)
| | | | | | - Li Yang Hsu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Asok Kurup
- Mount Elizabeth Medical Centre, Mount Elizabeth Hospital, Singapore
| | | | | | - Dale Fisher
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Schinasi L, Wing S, MacDonald PDM, Richardson DB, Stewart JR, L Augustino K, Nobles DL, Ramsey KM. Medical and household characteristics associated with methicillin resistant Staphylococcus aureus nasal carriage among patients admitted to a rural tertiary care hospital. PLoS One 2013; 8:e73595. [PMID: 23991200 PMCID: PMC3753306 DOI: 10.1371/journal.pone.0073595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 07/26/2013] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Methicillin resistant Staphylococcus aureus (MRSA) poses a threat to patient safety and public health. Understanding how MRSA is acquired is important for prevention efforts. This study investigates risk factors for MRSA nasal carriage among patients at an eastern North Carolina hospital in 2011. METHODS Using a case-control design, hospitalized patients ages 18 - 65 years were enrolled between July 25, 2011 and December 15, 2011 at Vidant Medical Center, a tertiary care hospital that screens all admitted patients for nasal MRSA carriage. Cases, defined as MRSA nasal carriers, were age and gender matched to controls, non-MRSA carriers. In-hospital interviews were conducted, and medical records were reviewed to obtain information on medical and household exposures. Multivariable conditional logistic regression was used to derive odds ratio (OR) estimates of association between MRSA carriage and medical and household exposures. RESULTS In total, 117 cases and 119 controls were recruited to participate. Risk factors for MRSA carriage included having household members who took antibiotics or were hospitalized (OR: 3.27; 95% Confidence Interval (CI): 1.24-8.57) and prior hospitalization with a positive MRSA screen (OR: 3.21; 95% CI: 1.12-9.23). A lower proportion of cases than controls were previously hospitalized without a past positive MRSA screen (OR: 0.40; 95% CI: 0.19-0.87). CONCLUSION These findings suggest that household exposures are important determinants of MRSA nasal carriage in hospitalized patients screened at admission.
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Affiliation(s)
- Leah Schinasi
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
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26
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Ferrara MS, Courson R, Paulson DS. Evaluation of persistent antimicrobial effects of an antimicrobial formulation. J Athl Train 2012; 46:629-33. [PMID: 22488188 DOI: 10.4085/1062-6050-46.6.629] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is becoming more prevalent in healthy athletic populations. Various preventive measures have been proposed, but few researchers have evaluated the protective effects of a prophylactic application of a commercially available product. OBJECTIVE To compare the persistent antimicrobial properties of a commercially available antimicrobial product containing 4% chlorhexidine gluconate (Hibiclens) with those of a mild, nonmedicated soap (Dr. Bronner's Magic Soap). DESIGN Cross-sectional study. SETTING Microbiology laboratory, contract research organization. PATIENTS OR OTHER PARTICIPANTS Twenty healthy human volunteers. INTERVENTION(S) The test and control products were randomly assigned and applied to both forearms of each participant. Each forearm was washed for 2 minutes with the test or control product, rinsed, and dried. At, 1, 2, and 4 hours after application, each forearm was exposed to MRSA for approximately 30 minutes. MAIN OUTCOME MEASURE(S) Differences in numbers of MRSA recovered from each forearm, test and control, at each post-application time point were compared. RESULTS Fewer MRSA (P < .0001) were recovered from the forearms treated with the test product (4% chlorhexidine gluconate) than from the forearms treated with the control product (nonmedicated soap). CONCLUSIONS The 4% chlorhexidine gluconate product demonstrated persistent bactericidal activity versus MRSA for up to 4 hours after application.
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Affiliation(s)
- Michael S Ferrara
- Department of Kinesiology, University of Georgia, Athens, GA 30602, USA.
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Update on the prevention and control of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA). Int J Antimicrob Agents 2012; 39:193-200. [DOI: 10.1016/j.ijantimicag.2011.09.029] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 09/30/2011] [Indexed: 12/15/2022]
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Balma-Mena A, Lara-Corrales I, Zeller J, Richardson S, McGavin MJ, Weinstein M, Pope E. Colonization with community-acquired methicillin-resistant Staphylococcus aureus in children with atopic dermatitis: a cross-sectional study. Int J Dermatol 2011; 50:682-8. [PMID: 21595661 DOI: 10.1111/j.1365-4632.2010.04751.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Bacterial infection with Staphylococcus aureus is a common complication of atopic dermatitis (AD). The incidence of community-acquired methicillin-resistant S. aureus infection (MRSA) in the AD population is unknown. OBJECTIVES This study aimed to assess the prevalence of S. aureus and MRSA in pediatric patients with AD, to compare disease severity, and to characterize the clonal diversity of the isolates. METHODS We carried out a prospective, cross-sectional study of 200 patients with AD. The severity of AD was defined as mild, moderate, or severe depending on a composite AD severity score. A swab was taken from the nares of each patient and another from affected skin or folds. Genotyping of all S. aureus isolates was conducted by polymerase chain reaction (PCR) amplification of the S. aureus protein A (spa) gene. RESULTS According to the severity score, 66.5% of subjects were ranked as having mild AD, 29.5% as having moderate and 4% as having severe AD. Staphylococcus aureus colonization was seen in 61.5% of all patients, represented by 43.7% of skin swabs and 48% of nares swabs. Only one of the isolations represented MRSA. Older age and higher AD severity scores were associated with S. aureus colonization (P = 0.03 and P < 0.001, respectively). No significant associations were noted for attendance at day care, family members with frequent skin infections, or family members working in healthcare. Isolates from spa CC015 were cultured in 19.2% of patient samples. The single MRSA culture showed a new spa type that belonged to CC127. CONCLUSIONS The results of this study confirm a high rate of S. aureus colonization of pediatric patients with AD. The low rate of MRSA requires further proof from larger prospective studies.
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Affiliation(s)
- Alexandra Balma-Mena
- Division of Pediatric Dermatology, Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
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Hansra NK, Shinkai K. Cutaneous community-acquired and hospital-acquired methicillin-resistant Staphylococcus aureus. Dermatol Ther 2011; 24:263-72. [PMID: 21410616 DOI: 10.1111/j.1529-8019.2011.01402.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The clinical presentation of methicillin-resistant Staphylococcus aureus (MRSA) infection ranges from asymptomatic colonization to cutaneous and invasive involvement. This review discusses the cutaneous presentations of community-acquired MRSA (CA-MRSA) and hospital-acquired MRSA (HA-MRSA) that one may encounter in the hospital or outpatient setting. Cutaneous CA-MRSA and HA-MRSA are often clinically indistinguishable, although they have different epidemiologic profiles and virulence factors. Bacterial culture is necessary for diagnosis and guides treatment, as infection with CA-MRSA and HA-MRSA require distinct clinical management. Guidelines for surgical interventions and antibiotic treatment of CA-MRSA and HA-MRSA will be discussed. Strategies for MRSA decolonization and prevention of further spread will also be reviewed.
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Affiliation(s)
- Nina Kaur Hansra
- Department of Dermatology, University of California-San Francisco, 1701 Divisadero Street, San Francisco, CA 94143, USA
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Tong SY, Steer AC, Jenney AW, Carapetis JR. Community-associated Methicillin-resistant Staphylococcus aureus Skin Infections in the Tropics. Dermatol Clin 2011; 29:21-32. [DOI: 10.1016/j.det.2010.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Frei CR, Makos BR, Daniels KR, Oramasionwu CU. Emergence of community-acquired methicillin-resistant Staphylococcus aureus skin and soft tissue infections as a common cause of hospitalization in United States children. J Pediatr Surg 2010; 45:1967-74. [PMID: 20920714 DOI: 10.1016/j.jpedsurg.2010.05.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 05/04/2010] [Accepted: 05/06/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) was first observed in pediatric patients in the late 1990s. Since then, possible risk factors for contracting CA-MRSA have been hypothesized, but supporting studies are limited. METHODS We analyzed hospital discharge records for patients with a principal International Classification of Diseases, Ninth Revision code for skin and soft tissue infections, collected from 1996 to 2006 by the United States National Center for Health Statistics. Noninstitutional, short-stay hospitals in the United States participated. The sample was limited to patients aged ≤19 years. Staphylococcus aureus and CA-MRSA were defined by International Classification of Diseases, Ninth Revision codes. Data weights were used to derive regional and national estimates. Population estimates were obtained from the US Bureau of the Census, and incidence rates were reported per 100,000 persons. Risk factors for CA-MRSA were first identified using χ(2) and χ(2) goodness-of-fit tests, then by multivariable logistic regression. RESULTS These data represent 616,375 pediatric discharges for skin and soft tissue infections from U.S. hospitals between 1996 and 2006. This represents approximately 69.9 hospitalizations for skin and soft tissue infections per 100,000 U.S. children per year. Staphylococcus aureus and CA-MRSA accounted for 19.6% and 9.6% of these cases, respectively. The rate of hospitalization for CA-MRSA skin and soft tissue infections increased dramatically over the study period; from less than one case per 100,000 in 1996 to 25.5 cases per 100,000 in 2006. Rates of CA-MRSA varied by region, with the South region having the highest rate (11.5 per 100,000 US children), followed by the West (5.2), Northeast (3.4), and Midwest (3.2). Peak CA-MRSA incidence occurred from May to December; however, the incidence in the South region was consistently higher than other regions for most months and the period of peak incidence was longer than other regions. Independent risk factors for CA-MRSA included survey year, race, geographic region, hospital size, and health insurance status (P < .0001 for all risk factors). CONCLUSIONS Pediatric hospitalizations for methicillin-susceptible S. aureus and CA-MRSA skin and soft tissue infections are on the rise. Possible risk factors for CA-MRSA infection include White race, residence in the South region of the United States, and lack of health insurance.
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Affiliation(s)
- Christopher R Frei
- The University of Texas at Austin, College of Pharmacy, Austin, TX 78712, USA.
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Smith TC, Moritz ED, Leedom Larson KR, Ferguson DD. The environment as a factor in methicillin-resistant Staphylococcus aureus transmission. REVIEWS ON ENVIRONMENTAL HEALTH 2010; 25:121-134. [PMID: 20839557 DOI: 10.1515/reveh.2010.25.2.121] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In recent years, methicillin-resistant Staphylococcus aureus (MRSA) has become a leading cause of infectious disease morbidity and mortality in the United States. The epidemiology of the organism has changed, with novel strains emerging in the community among individuals lacking any healthcare contact. Although direct human-to-human transmission via skin contact is one way for this organism to spread, transmission via environmental contamination of fomites or through air are other potential ways that the organism can be acquired. As such, an improved understanding of MRSA transmission is needed to implement maximally effective control and prevention interventions. We review the research documenting the role of the environment in MRSA spread.
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Affiliation(s)
- Tara C Smith
- Center for Emerging Infectious Diseases, Coralville, LA 52241-3471, USA.
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2009; 17:66-73. [PMID: 19225308 DOI: 10.1097/moo.0b013e32832406ce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Buss BF, Mueller SW, Theis M, Keyser A, Safranek TJ. Population-Based Estimates of Methicillin-Resistant Staphylococcus aureus (MRSA) Infections Among High School Athletes—Nebraska, 2006–2008. J Sch Nurs 2009; 25:282-91. [DOI: 10.1177/1059840509333454] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of skin and soft-tissue infections among athletes. To determine statewide incidence among high school athletes, we surveyed all 312 Nebraska high schools regarding sport programs offered, program-specific participation numbers, number of athletes with physician-diagnosed MRSA infections, and athlete’s sport at infection onset. Among 271 (86.9%) schools responding, MRSA infections were reported among one or more athletes by 4.4% (12/270) and 14.4% (39/271) during school years 2006–2007 and 2007–2008, respectively. From 2006–2007 to 2007–2008, MRSA incidence per 10,000 wrestlers increased from 19.6 to 60.1, and incidence per 10,000 football players increased from 5.0 to 25.1. We did not identify differences in distribution of MRSA infections on the basis of grade, school enrollment, location, or number of participants per team. Incidence of reported MRSA infections among football players and wrestlers was substantially higher during 2007–2008, compared with 2006–2007.
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