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We need more research on MRSA and our sports fields
14 Nov, 2007 By: Ron Hall Athletic Turf News
We called them strawberries and perhaps athletes still do. They’re those reddish abrasions, usually about the size of a silver dollar that athletes get on their knees or elbows as they skid on a hard or abrasive surface such as the clay on a baseball infield, hardwood of a basketball court or poly surface of an artificial turf sports field.
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We wore our strawberries with pride. They, and whatever other bumps and bruises we acquired in the heat of competition, told the world (or perhaps a certain cheerleader or majorette) that we were willing to sacrifice even injury for the glory of our team and our school.
We were tough, right?
It’s not such a good thing to be so foolishly tough these days.
One crazy bad bug
A miniscule bacterium called MRSA, pronounced mers-sa is tougher.
MRSA is the acronym for methicillin-resistant staphylococcus aureus, and it has literally brought even 300-lb. professional football players to their knees. MRSA is one variation (likely a mutation) of the common staphyloccous bacteria. Experts say as many as 20% of us carry staphylococcus and probably don’t even know it. It resides on our skin and in our noses. Generally it doesn’t cause a problem, but when it enters through an opening of the skin or an abrasion, it can cause a painful boil or a pimple.
But there are two more dangerous types of staphylococcus now. Both are resistant to most commonly used antibiotics. The two types are commonly referred to as hospital-acquired MRSA (HA-MRSÅ) and community-acquired MRSA (CA-MRSA). The later is the strain that most concerns school and athletic officials, and for good reason.
An epidemic
Almost daily somewhere in the United States a student or a group of students, often young athletes, are being diagnosed with CA-MRSA infections. These reports are all over the media all of a sudden and are causing genuine concern with school officials, parents and the students themselves. If a CA-MRSA infection is not diagnosed correctly and treated promptly, usually with a “Cadillac” anti-biotic, it can enter the student’s blood, internal organs or bone. The results can be catastrophic. CA-MRSA infections can affect even a healthy student's internal organs or bones and cause death. In fact, an estimated 19,000 deaths a year in the United States are being blamed on staph infections the great majority arising from HA-MRSA infections of patients with weakened immune systems in health care facilities. But there have been scattered reports of students who have contracted the bacteria at their schools and have died, including one highly publicized case of a 17-year-old male athlete in Virginia.
Determining how and where students acquire CA-MRSA can be puzzling to school officials, who often seem almost as undecided about how to respond. Reports so far suggest that many of students that become infected with CA-MRSA are athletes or, at least, have participated in some sort of group activity where they’ve been in close contact with other students, or with their schoolmate’s personal effects.
Answers still elusive
Where did this so-called “super bug” come from? And why has it suddenly reached what some health experts are describing as an epidemic? While the answer to the first question appears to be that it mutated to its present form in response to widespread and, perhaps, improper use of common antibiotics, why it has suddenly become such a problem remains unclear clear-cut right now.
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What is known is that HA-MRSA has been around much longer than CA-MRSA, not that it was a large blip on the public’s radar screen. Certainly hospitals and nursing homes didn’t go out of their way to apprise patients (or the public either) of the threat of this potentially deadly germ. As for CA-MRSA, it’s been known about since at least 1997. But it could to have been present earlier. Infections arising from MRSA apparently are often apparently misdiagnosed as insect or spider bites, health experts say.
Heads up turf managers
So, what does CA-MRSA have to do with sports turf managers?
The short answer is plenty.
There have been claims that CA-MRSA may survive (at least temporarily) in sports fields, including synthetic fields, thousands of which have been installed worldwide this past decade. Most of these fields feature a layer of rubber particles, sand or sometimes a combination of rubber and sand at the base of the poly fibers. The fibers, usually polyethylene, give the field its grass-like appearance and texture.
Testing done on natural grass fields and the crumb rubber collected from several synthetic fields in June several summers ago by Dr. Andrew McNitt, associate professor of soil science at Penn State University, failed to discover the presence of MRSA bacteria.
But, a recent study by an independent testing laboratory in Midland, MI, confirmed MRSA in the synthetic turf field it tested at a university. The university was unnamed in the report. (Report available upon request.)
From a practical standpoint, experienced sports field managers still openly wonder if CA-MRSA can survive on a synthetic field under conditions of intensive sustained use, and under environmental conditions favorable to the survival of microbes. The ability to support morning-to-evening or multiple uses under almost all weather conditions — a regimen that would quickly turn a turfgrass field into a bog — is the reason why many synthetic fields are installed in the first place.
What to do?
But, even if artificial turf (outside or under roof) can harbor CA-MRSA under certain conditions, would special treatments or applications of disinfectants, even on a regular basis, protect field users from infections? That's yet to be determined, and it's putting turf managers in a difficult position. Indeed, apart from basic maintenance and cleaning of the fields they're responsible for, what should turf managers do to reduce the liklihood of CA-MRSA infections in field users? Should they recommend the use of special coatings or treatments, perhaps even regularly scheduled treatments, to protect athletes?
The “dirty rug” argument is being used to sell special coatings and disinfectant treatments and services for synthetic sports fields. Many companies are beginning to promote products and services to safeguard field users from the threat of CA-MRSA infections. These are often the same (or very similar) products and services being offered to and eagerly purchased by schools to sanitize equipment such as weight benches, wrestling mats and just about everything else that athletes and students contact on a regular basis.
Indeed, this rash of CA-MRSA infections in our schools, which has ignited a crescendo of media coverage, has prompted drastic reactions from school officials, everything from closing schools temporarily to canceling sporting events. More are now instructing school personnel or hiring contractors to regularly disinfect school facilities, including sports fields.
Simple precautions
Are these over-reactions? The problem is so new and unprecedented that there seems to be no consensus of opinion on the best course of action when CA-MRSA strikes. But everyone agrees on a greater emphasis on prevention. Health experts say the incidence of CA-MRSA infections can be reduced by:
— frequent hand washing and attention to personal hygiene,
— covering all wounds and abrasions with sterile wraps and bandages,
— not sharing personal effects such as towels, razors and
— washing practice and game apparel, and disinfecting sports facilities and equipment regularly.
Where does the sports turf manager fit into this picture? That hasn’t been defined yet at many schools or sports facilities. But certainly the turf/sports field manager (whether a trained turf professional, a coach, athletic director or a school custodian) has to become as knowledgeable and proactive about CA-MRSA as other professionals in his/her particular organization.
Beyond that, there remains a great need for additional research into CA-MRSA and, in the case of sports fields, the liklihood of its incidence, survival and transmission to athletes on both turfgrass and synthetic turf surfaces. The results of this research would provide field maintainers with better guidance on cleaning and possibly even disinfecting the facilities under their care.
A lot has changed since me and my high school teammates prided ourselves on our physical prowess, including sporting our athletic wounds for all to see, not to mention wearing the same practice uniforms for days, and sometimes weeks, at a time before giving them a thorough cleaning.
We didn’t know what we didn’t know. The same, to one degree or another, is true for today sports field managers and maintainers. How much they will have to change their programs to meet challenges such as CA-MRSA is unclear. But change is almost certain.
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