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Joann M. Lindenmayer, DVM, MPH; Susan Schoenfeld, RN, MSPH; Robert O'Grady; Jan K. Carney, MD, MPH

Arch Intern Med. 1998;158:895-899.

Objectives  To describe a community outbreak of methicillin-resistant Staphylococcus aureus (MRSA) and to investigate risk factors for MRSA transmission and infection in a wrestling team.

Design  Case series and retrospective cohort study.

Setting  A high school wrestling team and the surrounding community in southern Vermont, 1993 to 1994.

Patients or Other Participants  The case series included persons whose MRSA-positive infections were identified at a hospital laboratory from January 1, 1993, through February 28, 1994, and a health maintenance organization laboratory from July 1, 1993, through February 28, 1994. A wrestling team case-patient was a 1993-1994 team member with an MRSA-positive culture during the period from January 1, 1993, through February 28, 1994.

Interventions  Visual inspection of wrestlers before matches was instituted. Affected wrestlers were excluded from wrestling and advised to seek appropriate medical care. Heightened attention was given to personal and environmental hygiene.

Main Outcome Measures  Colonization or infection with MRSA.

Results  Seven of 32 team members were MRSA positive (6 infected, 1 colonized). All lesion-positive wrestlers were tested by pulsed field gel electrophoresis and found to be infected with the same MRSA strain, as were 6 nonwrestlers. No risk factors for MRSA infection were identified.

Conclusions  The MRSA was transmitted among members of a wrestling team. Infection with MRSA should be suspected in outbreaks of boils that are nonresponsive to standard antibiotic therapy among healthy participants of contact sports and their close contacts.

From the Epidemic Intelligence Service, Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Lindenmayer); and the Vermont Department of Health, Burlington (Ms Schoenfeld, Mr O'Grady, and Dr Carney). Dr Lindenmayer is now with the Department of Community Health, Brown University School of Medicine, Providence, RI.

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