What causes staphylococcal (Staph) infections in wrestlers?

Staph Infections in Wrestlers: Causes and Prevention

Staph infections in wrestlers primarily occur through skin-to-skin contact, skin breaks from trauma, sharing of equipment/clothing, and contact with contaminated surfaces like wrestling mats. 1

Transmission Mechanisms

Wrestlers are particularly vulnerable to staphylococcal infections due to:

1. Direct skin-to-skin contact - The constant physical contact during wrestling provides an ideal transmission route 1, 2
2. Skin trauma - Breaks in skin integrity from:
   • Abrasions during matches
   • "Turf burns" on wrestling mats
   • Other skin injuries that create entry points 1, 3
3. Shared equipment and surfaces:
   • Wrestling mats (documented MRSA colonization)
   • Towels, clothing, and protective equipment
   • Locker rooms and shower facilities 1, 4
4. Poor hygiene practices:
   • Not showering immediately after practice/competition
   • Improper laundering of uniforms and practice clothing
   • Sharing personal items like razors or soap 1, 4

Risk Factors for Staph Infections

• High colonization rates - Studies show 4-23% of athletes have S. aureus colonization, with wrestlers having particularly high rates 1
• Frequency of training - More weekly training days increases exposure risk 4
• Higher BMI - Associated with increased risk of infection 1
• Previous skin conditions - History of pharyngitis, sinusitis, or skin manifestations 4
• Delayed showering - Not showering immediately after practice increases risk 4

Clinical Presentation

Staph infections in wrestlers typically present as:

• Solitary or multiple tender, erythematous abscesses with surrounding cellulitis
• Folliculitis, impetigo, or carbuncles
• Commonly located in axillary regions, buttocks, or thighs 3

Prevention Strategies

1. Personal hygiene:

   • Immediate showering after practice/competition
   • Regular laundering of uniforms and practice clothing
   • Proper hand washing techniques 1, 5

2. Equipment management:

   • Avoid sharing personal items (towels, razors, soap)
   • Regular cleaning of protective equipment
   • Daily cleaning of wrestling mats and surfaces 1

3. Facility maintenance:

   • Regular (daily, weekly, monthly) cleaning protocols for:
     • Weight rooms
     • Locker rooms
     • Shower facilities
     • Wrestling mats 1

4. Screening and isolation:

   • Routine skin checks before practices and competitions
   • Prompt identification and treatment of infected individuals
   • Following return-to-participation guidelines 1, 5

Management of Outbreaks

When staph infections occur among wrestlers:

1. Prompt identification of infected individuals
2. Proper treatment with appropriate antibiotics based on susceptibility
   • For MRSA infections, vancomycin may be required 6
3. Isolation of infected athletes until criteria for return are met
4. Return-to-participation guidelines:
   • Completion of 72 hours of antibiotic therapy
   • No new skin lesions for 48 hours before competition
   • No moist, exudative, or draining lesions 1

Common Pitfalls to Avoid

• Delayed diagnosis - Bacterial cultures should be obtained to confirm diagnosis and determine antibiotic susceptibility 3
• Inadequate treatment - Empiric treatment for methicillin-sensitive S. aureus may fail if MRSA is present 3
• Premature return to participation - Following strict return guidelines is essential to prevent spread 1, 5
• Focusing only on treatment - Prevention through hygiene and environmental cleaning is equally important 1

By implementing comprehensive prevention strategies and promptly addressing infections when they occur, the risk of staph infections among wrestlers can be significantly reduced.