High school athletic departments as sentinel surveillance sites for community-associated methicillin-resistant staphylococcal infections.

Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging infection in athletes. Our study assessed MRSA burden in Texas 4A and 5A high school athletic departments by contacting 447 licensed athletic trainers (LATs) regarding skin infections in athletes; 186 (41.6%) responded. Sixty LATs reported MRSA in their athletic departments. The largest MRSA outbreak (23 infected persons) occurred in football players. The trainers also reported MRSA in wrestlers, volleyball players, cross-country runners, nonathlete students, and adults. Students and adults involved in high school athletics require MRSA intervention because of their large numbers and extensive contacts. Physicians should be aware of the potential for MRSA and should culture rather than treat empirically, communicate with school health staff to maximize surveillance for affected students when MRSA occurs in their student community, and contact their health department when the number of students with MRSA meets the unusual group expression, outbreak, or unusual severity criteria.