Contagion® takes a closer look at how Staphylococcus aureus infections continue to plague professional sports players.
When “Ultimate Fighter” James Krause first got a cut on his leg, he didn’t think much of it. After all, he’s a professional fighter, trained in mixed martial arts (MMA), Jui Jitsu, and cage fighting. When that cut didn’t heal, Krause headed for the hospital, where he learned that he had contracted a “nasty” Staphylococcus aureus (staph) infection while filming a television reality show called “The Ultimate Fighter.”
He spent nearly two weeks in the hospital and had three surgeries to clean out the infection. “Third time in 10 years having staph and the earliest I’ve caught it,” he posted on Instagram along with a photo of his stitched-up incision, which was nearly a foot long. Krause is just the latest professional fighter to contract such an infection and post all the gory details on social media. For example, Kenny Florian (MMA) was pulled out of his fighting season early in 2010 to deal with an extremely swollen knee as a result of a staph infection; Jason “Mayhem” Miller blamed a 2009 MMA bout for a lesion on his neck that developed its own viral personality on MMA forum boards; the show, “The Ultimate Fighter,” has its own staph-related medical history with an undisclosed number of participants contracting infections during the show’s filming of various seasons.
When a professional athlete contracts a staph infection, it tends to make headlines, and not just because of the athlete’s fan base. S. aureus is considered by global healthcare leaders like Merck to be the “most dangerous of all the many common staphylococcal bacteria,” thanks to its tendency to be antibiotic-resistant, and the fact that it may spread easily if an individual is unaware that he or she is infected. In fact, some strains of S. aureus are resistant to so many antibiotics that they are nearly untreatable and must be surgically removed from the body to limit the spread of infection. This type of staph, called methicillin-resistant Staphylococcus aureus (MRSA), may be acquired in the general community or during a visit to a healthcare facility.
Gymnasiums, locker rooms, and other high-traffic areas where large volumes of bodily fluids like sweat and blood may be left behind by numerous people are prime growing grounds for S. aureus. Bacteria may spread via direct contact with an infected individual, through the use of contaminated objects like free weights, or by otherwise bringing infected fluids from the carrier into the body.
“Staph is the cockroach of bacteria,” observed Jeanine Thomas, founder and president of MRSA Survivors Network, to Contagion®. “We keep throwing antibiotics and treatments at it, and it just keeps finding a way to spread and survive. We don’t really even know how many community [MRSA] infections there are.” Furthermore, Thomas noted, many people with staph and even MRSA infections are asymptomatic. “Somewhere between 2% and 10% of the US population is actually colonized with MRSA,” she said. “All you need is a micro-cut, and staph or MRSA can go invasive even if you did not have any symptoms before... You can spread the infection without ever having symptoms.”
As Krause’s familiarity with staph indicates, S. aureus infections are no stranger to professional sports locker rooms. In 2008, star quarterbacks Tom Brady and Peyton Manning both contracted staph infections. At the time, Brady, who is notoriously secretive about all health conditions, underwent what Time described as “at least two additional infection-related procedures,” after ending his season early in September of that year, allegedly to deal with a knee injury. The National Football League (NFL) received a great deal of criticism at the time when Cleveland Browns tight end Kellen Winslow Jr. revealed that not only did he have a staph infection, but that allegedly the Browns had asked him to “cover it up” publicly, which is not uncommon for professional sports teams that do not want the competition to know when their stars are out sick. Six other Browns players reportedly had staph between 2005 and 2008. The Browns denied Winslow’s accusations and suspended him for a game.
Staph infections are probably most prevalent in “locker-room sports,” like football and wrestling, but they can be acquired just about anywhere. Professional skateboarder Nick Mullins contracted a staph infection, his family believes, when, in 2009, he got what his father called a “bad scrape” on his hip from a skateboarding accident; the cut eventually became infected. Mullins was not immediately diagnosed with staph or MRSA and ended up in septic shock before the diagnosis was made. He eventually lost all vision, suffered acute kidney injury (AKI), and sustained a great deal of lung damage, but did survive. Mullins made headlines during his months-long illness and during his recovery, when he eventually insisted on returning to skateboarding despite being legally blind. Mullins’ doctor noted that MRSA does not usually cause blindness in survivors, but speculated at the time that bacterial blood meeting Mullins’ retinal artery could have caused him to lose his eyesight. Now, Mullins is once more a professional skateboarder.
Although it may be impossible to keep all locker rooms perfectly clean, there are a number of behavioral precautions that athletes at all levels should take to protect themselves from staph and MRSA infections. The Centers for Disease Control and Prevention (CDC) notes that “good personal hygiene” is only the first step. They recommend regular handwashing with “soap and water or using alcohol-based hand sanitizer” as a regular habit, but add that protecting skin and open wounds is also extremely important. The CDC cites wrestling, football, and rugby as sports where athletes are at most risk for staph and MRSA infections, but points out that, “MRSA infections have been reported among athletes in other sports such as soccer, basketball, field hockey, volleyball, rowing, martial arts, fencing, and baseball.”
According to Thomas, in the end, “Prevention is what will save lives."