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Football Players’ Socks: A Reservoir for Staphylococcal Species

Football Players’ Socks: A Reservoir for Staphylococcal Species. Lauren Quinn Public Health Internship Program The University of Texas Austin Mentor: Marilyn Felkner, DrPH Infectious Disease Surveillance and Epidemiology Branch Texas Department of State Health Services. Introduction.

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Football Players’ Socks: A Reservoir for Staphylococcal Species

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  1. Football Players’ Socks:A Reservoir for Staphylococcal Species Lauren Quinn Public Health Internship Program The University of Texas Austin Mentor: Marilyn Felkner, DrPH Infectious Disease Surveillance and Epidemiology Branch Texas Department of State Health Services

  2. Introduction

  3. CA-MRSA in Athletes • Sports: football, rugby, wrestling, and fencing

  4. Risk Factors in Athletes • Close contact with infected individuals • Skin damage(e.g. turf burns, cosmetic body shaving) • Sharing personal items • Football • Player position

  5. Equipment and Uniforms????

  6. Survival of staphylococci on inanimate surfaces • Hardy and may survive up to 7 months on dry inanimate surfaces • Recovered from many surfaces within the hospital • Limited research within community

  7. Survival on Fabric • Isolated from many material items • Binds readily to a variety of materials • Clothing of Athletes?????

  8. Purpose • To assess whether football players’ socks can serve as reservoirs for staphylococcal species, including S. aureus and MRSA

  9. Methods

  10. Central Texas high-school football team; 9th through 12th grade boys; single school district Sample Population

  11. Athletic Socks Unpackaged Packaged

  12. Sampling Procedure • Sample • 24 players/week for four weeks • One week of control socks (never been worn) • Distribute socks to players and worn during 45 minute practice. • Junior Varsity vs. Varsity • Degree of player contact • offensive/defensive ++++ • special teams ++ • weights/video +

  13. Collection and Transport • Collect socks and place into baggies • Transport to Clinical Bacteriology Lab at TDSHS in car.

  14. Laboratory Protocol Swatch Sample Nutrient Broth CHROM agar Plates (BBL and Hardy) ORSA Plate MSA Plate Possiblestaphylococcalcolonies BHI Slant API Staph (+) Blood Agar Slant After catalase Gram Stain(+) Coagulase(+) Catalase (+) E Test

  15. Primary Plating Media BBL CHROMagar Hardy CHROMagar

  16. Swatches in Nutrient Broth Sock swatches in enrichment broth

  17. Identification using API system

  18. Results

  19. Percentage of Players’ Socks vs Control Socks Positive for Bacterial Growth, Staphylococcal spp. and S. aureus

  20. Control Socks Positive for Growth Staphylococcal spp. by Source

  21. Players’ Socks Positive for Staphylococcal spp. by Source

  22. Players’ Socks Positive for Staphylococcal spp. By Practice Conditions

  23. Players’ Socks Positive for Staphylococcal spp. by Date

  24. Proportion of Positive Samples by Player

  25. aureus epidermidis lugdunensis sciurii caprae warneri xylosis lentus hominis saprophyticus cohnii haemolyticus Staphylococcal spp. Isolated

  26. Conclusions

  27. Conclusions • Socks serve as a reservoir for Staphylococci • 68% of players always or sometimes shed Staphylococci • A variety of species recovered, including those of medical significance • S. aureus, S. epidermidis, and S. saprophyticus

  28. Preventative Measures • Launder personal items after each use • Shower after practice or competition • Educate athletes about hygiene and viability of staphylococci in the environment • Disinfect training equipment • Do not share personal items

  29. Epidemiological Variables • No association • Sock source • Practice type • Practice conditions • Inconclusive association: date • Unknown association: distribution method

  30. Study Limitations • Use of two sock sources • Unpackaged • Packaged • Distribution of socks • Placement on bench • Directly distributed

  31. Future Studies • Repeat the study controlling the distribution variables • Carry out the study in high schools with and without active MRSA outbreaks • Conduct a similar investigation in athletes who participate in other high contact sports ( e.g. wrestling)

  32. Future Studies • Beyond Socks . . . . • Other pieces of the uniforms • Inanimate surfaces and objects • Training equipment • Turf • Benches

  33. Acknowledgements • TDSHS • Tamara Baldwin • Thomas Allen, L.A.T, Athletic trainer • The University of Texas at Austin • Dr. Leanne H. Field • Nancy Elder, Librarian

  34. Hardy Diagnostic

  35. Thank you to: The Centers for Disease Control and Prevention Office of Workforce and Career Development

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