New York Giants tight end Fells struggles with MRSA

New York Giants tight end Daniel Fells' struggle with methicillin-resistant staphylococcus aureus (MRSA) is not the first case of a football player being infected with this superbug, but it does show how grave this infection can be.

According to NFL.com, Fells has undergone multiple surgeries with more expected to treat the infection thought to have been transmitted through a cortisone injection he received to treat toe and ankle injuries. At one point, Fells was in danger of losing a foot, although that risk appears to have lessened.

MRSA originally was found mostly in hospital settings, but community acquired infections are now more common, especially among athletes.

And it is not just in professional sports. Last year, a Vanderbilt University study found college athletes in contact sports such as football had MRSA colonization rates ranging from 8 percent to 31 percent; the range in non-contact sports was 0 to 23 percent.

Staph bacteria can live on the skin or in the nose and then enter the body through an open wound.

The Centers for Disease Control and Prevention reports that less than two percent of the population are MRSA carriers, but the study found that athletes in contact sports are at higher risk of both colonization and infection because they have skin-to-skin contact during games and practices and often have cuts and scrapes that can get infected.

Phyllis Flomenberg, an infectious-diseases specialist and associate professor at the Sidney Kimmel Medical College of Thomas Jefferson University, explained that once MRSA gets into athletes, it is easy to spread around. It hangs out on surfaces in the training and locker rooms and on their skin, and when an athlete gets a cut, it can get infected.

As to whether the superbug could be spread through a cortisone injection, she said, "While it is unlikely, with any injection there is always a small chance to introduce infection."

MRSA starts as a skin infection, but it can spread to the small tissue, joints, bone, lungs, or even bloodstream, Flomenberg said. With an extensive infection, joint drainage and/or surgical removal of infected tissue might be needed along with antibiotics to improve healing.

Herbert Cushing, infectious-diseases expert and chief medical officer at Temple University Hospital, reassures that the infection is usually localized and not limb-threatening.

"While for a long time vancomycin was the only good antibiotic available to treat MRSA, there are better antibiotics available now," he said.

Prevention and early treatment seem to be the key. All sports equipment and facilities need to be cleaned regularly. And players should frequently wash their hands, practice good hygiene, and avoid sharing personal items.

They should also bandage all open wounds and watch for infection.

Tracey Romero is sports medicine editor of Philly.com and writes the "Sports Doc" blog, www.philly.com/sportsdoc.