Football Players’ Socks: A Reservoir for Staphylococcal Species
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Transcript of Football Players’ Socks: A Reservoir for Staphylococcal Species
Football Players’ Socks:A Reservoir for
Staphylococcal Species
Lauren QuinnPublic Health Internship Program
The University of Texas Austin
Mentor: Marilyn Felkner, DrPHInfectious Disease Surveillance and
Epidemiology BranchTexas Department of State Health
Services
Introduction
CA-MRSA in Athletes
Sports: football, rugby, wrestling, and fencing
Risk Factors in Athletes
Close contact with infected individuals
Skin damage(e.g. turf burns, cosmetic body shaving)
Sharing personal items Football
Player position
Equipment and Uniforms????
Survival of staphylococci on inanimate surfaces
Hardy and may survive up to 7 months on dry inanimate surfaces
Recovered from many surfaces within the hospital
Limited research withincommunity
Survival on Fabric
Isolated from many material items Binds readily to a variety of materials • Clothing of Athletes?????
Purpose
To assess whether football players’ socks can serve as reservoirs for staphylococcal species, including S. aureus and MRSA
Methods
Central Texas high-school football team; 9th through 12th grade boys; single school
district
Sample Population
Athletic Socks
Unpackaged Packaged
Sampling Procedure
Sample 24 players/week for four weeks One week of control socks (never been worn)
Distribute socks to players and worn during 45 minute practice.
Junior Varsity vs. Varsity
Degree of player contact offensive/defensive ++++ special teams ++ weights/video +
Collection and Transport
Collect socks and place into baggies
Transport to Clinical Bacteriology Lab at TDSHS in car.
Laboratory ProtocolSwatch Sample
Nutrient Broth
ORSA PlateORSA Plate MSA
Plate
CHROM agar
Plates (BBL and Hardy)
Possible staphylococcal colonies
BHI Slant
Catalase(+)
Gram Stain(+)
Coagulase(+)
API Staph
(+)
E Test
Blood Agar SlantAfter
catalase
Primary Plating Media
BBL CHROMagar Hardy CHROMagar
Swatches in Nutrient Broth
• Sock swatches in enrichment broth
Identification using API system
Results
Percentage of Players’ Socks vs Control Socks Positive for
Bacterial Growth, Staphylococcal spp. and S. aureus
Control Socks Positive for Growth Staphylococcal spp.
by Source
Number of Socks Unpackaged#(%)
Packaged#(%)
Cultured 4(100.0) 44(100.0)
Any Growth 4(100.0) 1(2.3)
With Staphylococcal spp.
1(25.0) 0(0.0)
Players’ Socks Positive for Staphylococcal spp. by
SourceNumber of Socks
Unpackaged#(%)
Packaged#(%)
p-value
Cultured 46(100.0) 124(100.0)
Staph spp. positive
32(69.6) 72(58.1) 0.17
Players’ Socks Positive for Staphylococcal spp. By Practice
Conditions
Number of Socks Outdoor(offense/defense &
special teams)
#(%)
Indoor#(%)
p-value
Cultured 134 (100.0) 36 (100.0)
Staph spp. + 80 (59.8) 24 (66.7) 0.45
Players’ Socks Positive for Staphylococcal spp. by
Date
Number of Socks
9/24/07#(%)
10/1/07#(%)
10/15/07#(%)
10/22/07#(%)
p-value
Cultured 46(100.0) 46(100.0) 42(100.0) 36(100.0)
Staph spp. + 32(69.6) 16(34.8) 32(76.2) 24(66.7) 0.0002
Proportion of Positive Samples by Player
Staphylococcal spp. Isolated
• aureus• epidermidis• lugdunensis • sciurii• caprae• warneri
• xylosis• lentus• hominis• saprophyticus• cohnii• haemolyticus
Conclusions
Conclusions
Socks serve as a reservoir for Staphylococci
68% of players always or sometimes shed Staphylococci
A variety of species recovered, including those of medical significance S. aureus, S. epidermidis, and S.
saprophyticus
Preventative Measures
Launder personal items after each use
Shower after practice or competition Educate athletes about hygiene and viability of staphylococci in the environment Disinfect training equipment Do not share personal items
Epidemiological Variables
No association Sock source Practice type Practice conditions
Inconclusive association: date
Unknown association: distribution method
Study Limitations
Use of two sock sources Unpackaged Packaged
Distribution of socks Placement on bench Directly distributed
Future Studies
Repeat the study controlling the distribution variables
Carry out the study in high schools with and without active MRSA outbreaks
Conduct a similar investigation in athletes who participate in other high contact sports ( e.g. wrestling)
Future Studies
Beyond Socks . . . . Other pieces of the uniforms Inanimate surfaces and objects
Training equipment Turf Benches
Acknowledgements
TDSHS Tamara Baldwin Thomas Allen, L.A.T, Athletic trainer
The University of Texas at Austin Dr. Leanne H. Field Nancy Elder, Librarian
Hardy Diagnostic
Thank you to:
The Centers for Disease Control and Prevention
Office of Workforce and Career Development