MRSA Infections in Professional Football Players:
Community vs. Healthcare-Acquired Infections

By Phenelle Segal, RN, CIC, President of Infection Control Consulting Services

The National Football League (NFL) continues to be plagued with outbreaks and instances of methicillin resistant Staphylococcus aureus (MRSA). The most recent case involves New York Giants player Daniel Fells who, as of the publication of this report, has undergone five surgeries in the past two weeks. His infection was so severe that surgeons were unsure whether they would be able to save his foot from amputation.

According to media sources, Fells received cortisone shots to an injured foot, presumably in an outpatient care setting. One week later, Fells was admitted to a hospital with a raging fever and pain. MRSA was diagnosed and intravenous antibiotic treatment begun.

The NFL has struggled with MRSA for more than a decade. Eleven years ago, Brandon Noble of the Washington Redskins contracted MRSA after undergoing an outpatient arthroscopy procedure. Within two years, several other players on the team had developed infections. Since then, other teams have experienced persistent problems with MRSA. Many players have been placed on the disabled list, which has affected them and the teams they represent.

Staphylococcus aureus, including MRSA, lives on the skin and in the nostrils (anterior nares) and serves as a protective mechanism, but if it enters the body via a procedure (surgery or needles), an open wound, mucous membrane or the bloodstream, it can turn deadly.

MRSA is found in persons that have never been hospitalized or entered any healthcare facility (community acquired) as well as in institutionalized patients who acquire it from person-to-person transmission and/or a contaminated environment. While it is very difficult to pinpoint the exact cause of Staphylococcus infections, both Fells and Noble underwent invasive procedures, which could have contributed to the acquisition of infection.

The athletic environment, including gymnasiums and locker rooms at sports centers, have been long thought of as a vehicle for transmission of organisms. Over the years, huge efforts have been undertaken to disinfect, refurbish and overhaul buildings, surfaces and areas that could contribute to the spread of infection. Many sports teams have spent hundreds of thousands of dollars to mitigate further issues, while some have downplayed this as “hype” and “overkill.”

The Fells case exposes the public to yet another high-profile person with an infectious disease that more than likely could — and should — have been avoided, while the public is generally unaware of the hundreds of thousands of patients in healthcare settings who struggle with these resistant organisms on a daily basis.

The healthcare community in particular, hospitals, have begun to see a reduction in MRSA cases due to stringent efforts by government agencies and regulatory bodies, but still have a long way to go to further reduce the incidence of these mostly avoidable infections that have dire consequences for patients, family members, healthcare facilities and their staff. The outpatient care setting is of primary concern as, despite the Centers for Disease Control and Prevention (CDC) guideline for prevention of transmission of infection released in 2012 for outpatient centers, most outpatient clinics, centers, physician offices and other providers are lacking in disease transmission policies, protocols and procedures.

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Infection Control Consulting Services (ICCS) provides infection control and prevention services to all sectors of healthcare, with an emphasis on outpatient settings. Services include on-site visits to assess existing infection control and prevention programs, development of customized written programs and policies/procedures to mitigate risk of infection transmission, development of risk assessments and assistance with corrective plans of action.