By Michael Hovan
For as long as athletic teams have been in close contact with one another, there have been outbreaks of community diseases. One of these diseases is MRSA, methicillin resistant Staphylococcus aureus. Whether it is in wrestling, football or others, MRSA and other diseases are almost a fact of life. However, over the last few decades, another key factor has been introduced to the equation; artificial turf. Artificial turf was hailed as the answer to the high maintenance grass fields. There is a dark side to artificial turf though and that is its ability to support bacteria and specifically MRSA.
MRSA is a form of Staphylococcus aureus that has developed resistance to the antibiotic methicillin and needs to be treated with stronger medications. People infected with MRSA can show symptoms that “first appear as reddened areas on the skin, or can resemble pimples that develop into skin abscesses or boils causing fever, pus, swelling, or pain”. MRSA is spread by person-to-person contact as well as coming in contact with an infected item. Breaks in the skin such as cuts and turf burn make it even easier for the bacteria to infect a person. Left untreated, MRSA infections can lead to serious complications and even death (1).
In a 2011 study, researchers found that MRSA was able to survive on artificial turf for extended periods of time. The amount of time that MRSA can survive on artificial turf depends heavily on whether they have the appropriate nutrition required to survive. In the study, the researchers used mucin as a type of nutritional supplement and found that it was enough for the bacteria to live off of for over a month (2). Mucin is a molecule that is found throughout the human body in mucus in the nose as well as in saliva and lining the epithelium of the mouth, throat and lungs. With the amount of saliva that ends up on turf fields over the course of practices and games, it is not hard to believe that MRSA colonies could survive for the extended times seen in the study in a real life situation.
In addition to the hazards presented by turf being able to support MRSA, there is another secondary effect of turf that contributes to an increased risk of MRSA breakouts among athletic teams. The plastic material that turf is made with leads to wounds known as turf burn that open the skin and allow a pathway for the bacteria to enter the body (3). Once the bacteria enters the body it binds to different tissues in the body and creates a protective biofilm (4). This biofilm protects the bacteria from the rest of the environment. Additionally, they may form abscesses and metastasize, or spread, to other parts of the body. The often transition to a hardier form (called small-colony forming MRSA) that makes them harder to eliminate (4) This, combined with the fact that community-associated MRSA (the kind that often spreads among athletic teams) is more infectious than typical MRSA, makes it extremely difficult to fight (4)
Currently there is very little being done to combat possible MRSA outbreaks. While they are not overly common, they are a problem. Already this year there was a MRSA outbreak affecting dozens of students, many football players, at Heidelburg University (5). The only proactive efforts by athletic training staff and schools is in the form of education. Schools should start taking proactive measures to prevent MRSA infections such as disinfecting turf fields on a regular basis rather than just being reactive when an outbreak has already occurred. Despite the extra expenses that this may incur, it is worth sparing athletes from a possibly life-threatening infection.
1. Community-Associated Methicillin-Resistant Staphylococcus Aureus (CA-MRSA) - Fact Sheet. 2007. Community-Associated Methicillin-Resistant Staphylococcus Aureus (CA-MRSA) - Fact Sheet. New York Department of Health.
2. Waninger KN, Rooney TP, Miller JE, Berberian J, Fujimoto A, Buttaro BA. Community-Associated Methicillin-Resistant Staphylococcus aureus Survival on Artificial Turf Substrates. 2011. Medicine & Science in Sports & Exercise. 43(5): 779-784.
3. Begier EM, Frenette K, Barrett NL, Mshar P, Petit S, Boxrud DJ, Watkins-Colwell K, Wheeler S, Cebelinski EA, Glennen A, Nguyen D, Hadler JL. 2004. A High-Morbidity Outbreak of Methicillin-Resistant Staphylococcus aureus among Players on a College Football Team, Facilitated by Cosmetic Body Shaving and Turf Burns. Clin Infect Dis. 39(10): 1446-1453. 10.1086/425313.
4. Gordon RJ, Lowy FD. 2008. Pathogenesis of Methicillin-Resistant Staphylococcus aureus Infection. Clin Infect Dis. 46(5):S350-S359. doi: 10.1086/533591.
5. Miller, Tim. "30 Cases of MRSA under Investigation at Heidelberg University; 4 Confirmed Cases." Toledo News Now. 14 Sept. 2015. Web. 15 Sept. 2015.
Michael Hovan is a biology major who is planning on attending medical school after graduation. He is a member of the Muhlenberg football team. He is an avid saltwater fisherman and a huge fan of the New York Rangers and New York Mets.