Ricky Lannetti, a senior wide receiver for Lycoming College in Williamsport, Pa., wasn't so lucky. He discovered what appeared to be a pimple on his buttocks as he was getting dressed for practice one afternoon in December 2003. He called his mother complaining of nausea on a Tuesday, and by Saturday he was dead because of an MRSA infection.
The same fate might have befallen Bettineski, but the doctors finally turned to an antibiotic, Vancomycin, that was effective. It wasn't until a month later that he went back to work. He still hasn't recovered all the sensation in his leg, and there's no guarantee that he ever will. "I still consider myself very lucky," he says.
Unless you've washed your hands in the last few minutes, they probably have bacteria on them at this moment. The bacterium staphylococcus, or staph, is much like gunpowder--harmless under some conditions, lethal under others. About 33% of all people carry staph in their noses, but conditions have to be right for it to start to grow. It can adhere to a minor abrasion such as a turf burn and cause a superficial infection. And in some individuals the bacteria can spread into the blood and cause more severe illness. When a staphylococcus infection does develop, it's usually easily treatable with antibiotics from the penicillin family, such as cloxicillin or cephalexin.
But when an antibiotic effectively treats an infection, a few bacteria still survive, and, to paraphrase Nietzsche, what doesn't kill a germ makes it stronger. The bacteria that survive a dose of antibiotics can mutate into a more virulent strain that's resistant to those drugs, and therein lies a Catch-22: Powerful antibiotics are needed to combat bacteria, but their use helps drive the development of stronger germs. Along with our increasing reliance on antibiotics--in our food and with antimicrobial soaps, for instance--comes increasingly resistant strains.
It only takes the smallest opening in the skin for MRSA to infiltrate the bloodstream. The Rams' cases indicated that scrapes on the skin from artificial turf provided the entry point, and then the germ could have been passed around in any number of ways--by sharing towels, for instance, or using locker room facilities that weren't completely disinfected. "They thought it was in our hot tub because that was where the most guys congregated and it's hot, so germs can fester there," says tackle Kyle Turley. "So they quarantined the hot tub and came in one weekend and did some serious cleaning. They thought they had it nailed. Later on, guys were coming down with it again, and they came back and did some more tests. They found out it was actually in the cold tub. So they quarantined the cold tub, and that finally got rid of it."
MRSA is difficult to control for two main reasons: Its early symptoms are so benign that people with the infection often don't seek medical attention until it has begun to spread, and it can be passed so easily from one person to another. "An athlete has a cut or an abrasion that we bandage," Courson says. "As he comes off the practice field and is in the locker room or in the shower, he takes that bandage off and throws it on the ground. Then someone in bare feet steps on it. It can happen that easily."
Athletic staffs are trying their best to get players to adopt some basic changes in their behavior (box, above), but CDC researchers want the medical community to change its way of doing things as well. Doctors need to test for MRSA earlier in the treatment, in order to avoid prescribing useless drugs that merely give the bug precious time to spread. "Doctors need to be more judicious in their use of antibiotics in general," says CDC spokesperson Nicole Coffin-Ott. Otherwise new, more powerful strains of MRSA will continue to evolve, and athletes in every sport will have to learn how to play an entirely different form of defense. ?