Association Between Contact Sports and Colonization with Staphylococcus aureus in a Prospective Cohort of Collegiate Athletes
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Athletes have a higher risk of infection with Staphylococcus aureus than the general population. Most studies in athletes have included primarily male contact sports participants and have not assessed S. aureus carriage over time. We aimed to examine the epidemiology and risk factors of S. aureus carriage in a cohort of male and female collegiate athletes.
We conducted a prospective cohort study of 377 varsity collegiate athletes from August 2008 to April 2010. A baseline questionnaire ascertained risk factors for colonization. Nasal and oropharyngeal swabs were obtained at enrollment and monthly thereafter to detect S. aureus colonization. The primary outcome was S. aureus colonization, both with methicillin-susceptible and methicillin-resistant S. aureus, as defined by bacterial culture and molecular confirmation. Secondary outcomes were time to colonization with S. aureus and carriage profile, defined as non-carrier, intermittent carrier, or persistent carrier.
Overall, 224 contact sports and 153 non-contact sports athletes were enrolled. Contact sports athletes had a higher risk of carrying S. aureus over time: They had higher odds of being colonized with MRSA (OR 2.36; 95 % CI 1.13–4.93) and they tended to carry S. aureus for longer periods of time (intermittent carriage OR 3.60; 95 % CI 2.02–6.40; persistent carriage OR 2.39; 95 % CI 1.21–4.72). Athletes engaged in contact sports also acquired S. aureus more quickly (HR 1.61; 95 % CI 1.02–2.55).
Staphylococcus aureus carriage was common in contact sports athletes. These findings suggest that efforts to prevent transmission of S. aureus among athletes should be focused on contact sports teams.
KeywordsContact Sport SCCmec Type Multinomial Logistic Regression Model Sport Athlete Nasal Colonization
Community-associated methicillin-resistant Staphylococcus aureus
Methicillin-resistant Staphylococcus aureus
Methicillin-susceptible Staphylococcus aureus
Staphylococcal Cassette Chromosome mec
The authors recognize the nurses, students, trainers, sports medicine physicians, and team coaches that made this work possible. NJT had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Compliance with Ethical Standards
Conflict of interest
CBC has received research grants from Pfizer, Inc. for S. aureus vaccine research; Novartis Vaccines for S. aureus immune response studies; and Diatherix Laboratories for S. aureus diagnostic assays. Authors NJT, EJS, NS, BRS, IPT, and KME declare that they have no conflicts of interest.
This work was supported by the Division of Microbiology and Infectious Diseases from the National Institute of Allergy and Infectious Diseases at the National Institutes of Health [K23-AI074830] to CBC; the National Center for Research Resources [UL1 RR024975-01], and is now at the National Center for Advancing Translational Sciences [UL1 TR000445-06]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Research involving human participants
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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