Here's a must read article from this morning's KC Star for all wrestlers and their parents. rhill

Posted on Thu, Feb. 03, 2005

Staph striking healthy, athletic By KAREN UHLENHUTH and ALAN BAVLEY The Kansas City Star Physician Mary O'Connor has seen how quickly a troublesome and potentially dangerous new staph infection can move through the community.A high school wrestler with the antibiotic-resistant staph infection came to North Kansas City Hospital for treatment. In short order, said O'Connor, “three other wrestlers acquired it from him, and somebody from another team they wrestled with got it. And then his girlfriend got it, and then her father got it.”Since O'Connor, an infectious-disease specialist at the hospital, first ran across the resistant bug in the spring of 2002, she and two other doctors north of the river have treated more than 100 people with it.The bacterium is a strain of Staphylococcus aureus that is resistant to the antibiotics, like methicillin, that are commonly used to treat routine staph infections. Fighting these defiant skin infections demands powerful and costly drugs. It can turn open sores into large, painful boils, sending people to the hospital for surgery and intravenous antibiotics.Methicillin-resistant staph is turning up in more and more places across the country. And it's causing thousands of infections among such diverse groups as prison inmates, military recruits and children in day care.Athletes, particularly those in contact sports, are especially vulnerable.The St. Louis Rams found that out during the 2003 football season, when five of their 58 players, four linemen and a linebacker, developed infections. As players were sidelined, concerns grew and the U.S. Centers for Disease Control and Prevention was called in.A report today in The New England Journal of Medicine on the CDC's investigation documents plenty of poor hygiene practices that could have spread the germs, but never pinpoints the source of the infections.“We cultured the field, we absolutely covered the Rams' training room and we never got a good handle on where it came from,” said Bernard Garfinkel, a team physician for the Rams.“It could have been a sneeze, someone who didn't wash his hands properly. It could get on a machine. Staph is so prevalent, so widespread, it can come from anywhere.”This past season was infection-free, Garfinkel said, thanks to the use of germicidal hand cleaners and instructions to players and staff to wash their hands more often.Last season, though, the CDC found that players shared towels on the field, often didn't shower before using communal whirlpools and didn't routinely clean exercise weight-training equipment between uses.“They think they're healthy and strong and can resist anything, including infections,” said Sophia Kazakova, who led the CDC investigation.Staph and other bacteria develop resistance to antibiotics when the drugs are overused or used inappropriately.Antibiotic-resistant staph has long been a serious problem in hospitals. But the methicillin-resistant staph that's recently become prevalent outside of hospitals appears to have developed separately.While healthy people generally can withstand a methicillin-resistant staph infection, this strain of the bacteria may produce a toxin that is more likely to cause deep-seated skin abscesses. For the elderly and other people with compromised immune system, unchecked infections can spread to the bloodstream and become life-threatening.Doctors need to be alert to the possibility that the staph infection they encounter is methicillin resistant, Kazakova said: “What makes this a problem is physicians are using treatment that doesn't work, the commonly prescribed antibiotics.”Staph bacteria, which usually live benignly on the skin of about 30 percent of people, can cause trouble when they enter through scrapes, scratches or openings in the skin.That's why staph tends to infect people who engage in close-contact, rough-and-tumble sports such as football, rugby and wrestling.Last fall, for example, several members of the Blue Valley West High School wrestling team developed the skin sores that signal staph infection.“It cleared up for the most part without a lot of trouble,” said wrestling coach Randy Lowe. “We had a couple of kids that it lasted longer, and they had trouble getting rid of it.”The classic staph infection, said John Fried, an infectious-disease specialist with an office in Merriam, “is a boil, a pus pocket that is red, warm, tender and soft and gushy. Some look like a sunburn — red, warm and tender without being a full-blown abscess.”Some people also develop flu-like symptoms such as fever, chills and body aches, Fried said.Staph used to be easily and cheaply treated, he said. A visit or two to the family doctor and a $35 antibiotic prescription would do it. Killing methicillin-resistant staph isn't so easy. It often requires a biopsy, a culture, maybe more visits to the doctor and a much more expensive antibiotic.“There are only four good drugs for (methicillin-resistant staph),” Fried said. “Three are only available through an IV. That costs $1,000 to $2,000 per week. The one pill available costs about $600 a week. Needing expensive antibiotics really complicates the treatment.”Although this resistant form of staph until recently was “rare as hen's teeth” in his practice, Fried said, “one to three times a month I see a community-acquired staph infection and the patient has to go on an expensive IV antibiotic.”The NCAA has been warning athletic trainers about methicillin-resistant staph since 2003. Collaborating with the CDC, it has developed an education program on skin infections. And it has added resistant staph infections to its voluntary injury reporting system.“More and more people are seeing it, so the word's out,” said David Klossner, assistant director of education outreach for the NCAA.Because this newly energized microbe isn't consistently monitored across the country, the CDC is developing a system to track it. The agency also has made grants for research to better understand how resistant staph works. And it's trying to alert doctors about the problem.“Doctors need to know if it's circulating in their community,” said CDC spokeswoman Nicole Coffin. If it is, “They should do cultures of severe skin abscesses.”Anyone with a skin infection should have it seen by a doctor, Coffin added.“The key to all this … the take-home point, is prevention,” said Kathleen Hall-Meyer, infection control coordinator at St. Luke's South hospital. “We can prevent so much of this by good hand-washing and good hygiene. Even though this is resistant to drugs, it is not resistant to hand washing.”That means bathing every day, particularly after engaging in sports, she said. Keeping wounds covered is critical. And being on guard about sharing personal items like towels, razors or workout clothes.It's easy to transmit methicillin-resistant staph, but just as easy to prevent transmission, said O'Connor at North Kansas City Hospital.When O'Connor discovered a group of people who were unknowingly passing it around, she instructed them to stop sharing towels and soap. They went to freshly laundered towels and a pump-dispenser of liquid soap. The infection quickly dissipated.In another case, O'Connor advised an infected family to dump its community loofah sponge, a cozy home for staph.“Really simple things have stopped outbreaks,” she said.To reach Karen Uhlenhuth,call (816) 234-4783 or send e-mail to kuhlenhuth@kcstar.com.To reach Alan Bavley,call (816) 234-4858 or send e-mail to abavley@kcstar.com.