MRSA Prevention for Athletes – Is my locker room properly protected?

In this day and age of Super bugs, as a Coach, Manager or Athletic Trainer, you need to ask yourself, “Is my locker room properly protected from the MRSA bacterium”?

What is MRSA?

MRSA is Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium responsible for infections in humans with many of the infections difficult to treat due to the bacterium’s resistance to a large group of antibiotic called the beta-lactams, which include the penicillin and the cephalosporins.  MRSA is often sub-categorized as community-acquired MRSA (CA-MRSA) or health care-associated MRSA (HA-MRSA). Recent Reports have noted the USA 300 and 400 strains of CA-MRSA have evolved to community-acquired levels that attack the healthiest of children and professional athletes making it very different than the traditional strain of MRSA that affects the immune-compromised.  Given this, the importance of a disinfections program with proven efficacy against CA-MRSA 300 and 400 is paramount.

How is MRSA spread?

MRSA is predominately spread from person to person through direct skin contact or contact with shared items or surfaces (e.g., towels, used bandages, weight-training equipment, playground equipment, synthetic-turf, etc.) that have been in contact with a person's infection.  The bacterium is not carried through the air and does not live in soil. Given this, MRSA is spread more easily among athletes because they:

• Have repeated and frequent skin-to-skin contact.
• Acquire breaks in the skin such as cuts and abrasions that if left uncovered allow Staph and MRSA to enter and cause infection.
• Spend large amounts of time around items and surfaces that come into direct skin contact with the bacterium.

How do I protect my locker rooms against MRSA?

As the Coach, Manager and Athletic Trainer, you can be the primary line of defense against MRSA.  If you are this person, ask yourself, am I doing everything possible to protect my Staff, Players and Opposing Players from a MRSA infection?  To do so, a proper protocol for locker room cleanliness must be in place.  Be sure to contact your local Health Officials, District Administrators, Organizations Attorneys, etc. for input to ensure the protocol you develop is  proper, compliant with any adopted rules and/or  procedures and meets any legal requirements within your subject jurisdiction.  Here is a simple guideline for you to begin to develop your locker room protocols:

• Require the persons responsible for cleaning the locker room are using the disinfectants which kill the 300 and 400 strain of MRSA (many products claim killing of MRSA, but have not passed testing to kill these strains)
• Provide, in writing the cleaning procedures to all locker room cleaning personnel.

• Require all towels in the locker room or used during athletic activities are single use, and not shared.
• Eliminate the use of bar soap and install anti-microbial liquid or foaming soap stations.
• Preclude the sharing of any personal items such as razors, towels, etc.
• Require athletic training equipment be wiped down after each use with proper disinfectants.
• Carpet flooring is not recommended; if it is in use make sure it is disinfected regularly.
• Restrict the use of whirlpools to those players requiring them, and disinfect after each use.
• Encourage (or require) frequent hand washing with anti-microbial soaps.
• Provide any person with an open wound an individual bottle of anti-microbial soap for personal use.
• Develop a plan to educate players on proper hygiene.
• In conspicuous places, post the proper locker room protocols to be followed for all individuals (i.e.  “Notice – You are hereby expected to do your part to keep the locker room clean by …any person caught not following protocol will be punished accordingly”)
• Encourage (or require) testing of any Staff person or player suspected of a case of MRSA.
• Encourage (or require) the proper use of gloves for Staff treating players with any health related issues.

Is this a Guarantee?

In conclusion, no one can guarantee a case of MRSA will not occur, however taking proper preventative measures will greatly decrease the probability of an outbreak. When an outbreak occurs, many questions arise from Health Officials, Players, Parents, Staff, and School administrators, along with the traditional finger pointing.   This is especially true when opposing teams have visited your facility and are confronted with an outbreak.   If you have the proper protocols in place, including using the proper disinfectants you can be assured, to the best of your ability, all necessary precautions are being undertaken.