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1、Skin Infections In Athletics,W. Randy Martin, MD Infectious Disease Consultant Director, Sutter Roseville Wound Clinic,Skin Infections,The skin always has some amount of bacteria, fungus, and viruses living on it Skin infections occur when there are breaks in the skin and the organisms have uncontro
2、lled growth,How Infectious?,It is more important to understand the potential for infection rather than placing a name on a skin problem The priority is the health of the athlete When in doubt, err on the side of safety and well-being,Problem Skin Lesions,Always worry about lesions that have an irreg
3、ular border Worry about raised skin lesions Worry about “wet” or “moist” lesions,Problem Skin Lesions,Worry about skin lesions that have different colors within the lesion Bright red colored lesions are more of a problem compared to faded lesions Lesions that are warmer compared to other skin are mo
4、re likely to be infected.,Problem Skin Lesions,Patterns of skin lesions help determine how infectious the lesions have become Inflammation and irritation around the skin lesions increase the chance the lesions are infectious,Problem Skin Lesions,An athlete with a prior history of infectious skin les
5、ions has a higher risk of recurrent skin infections Skin abrasions increase the risk of skin infection. The deeper or more traumatic the break in the skin, the higher the risk for a subsequent infection,Expertise,The more experienced a medical person has with skin lesions, the better the medical eva
6、luation An physician experienced with skin lesions and infections is better than one with limited experience Legally the experienced matside physician evaluation is more important compared with a prior outpatient evaluation,Expertise,In some situations an experienced athletic trainer or referee may
7、have more expertise compared to a physician who has limited experience but this problem is difficult to objectively document The best situation is qualified physicians, trainers and referees working together for the benefit of the athletes.,Skin Infections - Highlights,Bacteria (can be cured) Staphl
8、ococcus including MRSA & Impetigo Streptococcus Fungal (can be cured) Ringworm Viral (cant be cured but can be treated) Herpes Warts Molluscum contagiosum,Skin Infections,The right antibiotic is required to cure a specific bacterial skin infection Antibiotics for bacteria will not improve fungal or
9、viral infections Bacterial infections can be the fastest growing infections and for this reason are the most easily spread among athletes,Skin Infections,The faster the bacteria grows, the more likely the correct antibiotic will cure the infection. Herpes gladitorium (Herpes simplex) responds the be
10、st to antiviral medication. Other virus infections are relatively resistant to current medications,Examples of Staph Infections,www.spapex.org/spapex/ impetigobulloso.jpg,Staph Infection,Chronic folliculitis due to Staphylococcus aureus infection,Folliculitis,Inflammation of hair follicle Frequently
11、 caused by infection Physical injury can cause problem Painless or tender pustule,What is MRSA?,The official name is Methicillin resistant Staphylococcus aureus. It is a “Staph” infection “Staph” and “Strep” bacteria often cause skin infections. MRSA is resistant to many of the traditional “Staph” a
12、ntibiotics,MRSA In Sports,1984 - rugby team in London1986 - outbreak of boils in football and basketball Kentucky1993 - 1st case of MRSA in a wrestling team in Vermont2002 - 03 MRSA boom! -Los Angeles county: athletes & county jail-Colorado, Indiana, and Pennsylvania fencers, football, & wrestlers20
13、04 - 05 high school, college, professional football and basketball,MRSA,Typically presents with an abscess May or may not have surrounding cellulitis Athlete may or may not have risk factors for infection,MRSA,Sports who haveathletes developinfections includeweight lifting, basketball, baseball,cano
14、eing, fencing, football, rugby, running (cross-country), soccer, softball, volleyball, and wrestling,How Do MRSA Infections Occur?,Touching someones MRSA-infected skin Touching surfaces that have MRSA on them, like doorknobs and light switches Sharing personal hygiene items (bar soap, towels, razors
15、) Overusing antibiotics, stopping them early, or missing doses,MRSA,How is MRSA treated?,By a healthcareprovider who may: Drain the infectionand/or Give the correctantibiotic and/or Help reduce the amount of bacteria on the skin.,Recurrent Infections,MRSA skin infections recur at a high rate Skin su
16、rface and fomite colonization appear to be as important as nasal colonization Alcohol-based disinfectants may be superior to detergent-based formulations,Stop Spreading MRSA!,Wash your hands often with warm,soapy water Use 60% alcohol-based hand sanitizerwhen soap and water are not available Shower immediately after practice and matches,Stop Spreading MRSA!,Do not share personal hygiene items (bar soap, towels, razors) or clothing Wear practice clothes/ uniforms only once, wash with soap and hot water, dry in hot dryer Cover all wounds with a clean, dry bandage taped on all four sides,
