By Stan Deresinski, MD, FACP, FIDSA

Clinical Professor of Medicine, Stanford University

Dr. Deresinski reports no financial relationships relevant to this field of study.

SYNOPSIS: Staphylococcus aureus, including methicillin-resistant S. aureus, is a frequent surface environmental contaminant on both children’s playgrounds and in adult fitness centers.

SOURCES: Thapaliya D, Kadariya J, Capuano M, et al. Prevalence and molecular characterization of Staphylococcus aureus and methicillin-resistant S. aureus on children’s playgrounds. Pediatr Infect Dis J 2019;38:e43-e47.

Dalman M, Bhatta S, Nagajothi N, et al. Characterizing the molecular epidemiology of Staphylococcus aureus across and within fitness facility types. BMC Infect Dis 2019;19:69.

A group of investigators examined environmental contamination by Staphylococcus aureus in two distinct settings in Ohio, one potentially affecting children and the other affecting adults. They collected 280 environmental samples from 10 playgrounds in northeast Ohio over three days in July 2016. Researchers recovered S. aureus in culture from 89/280 (31.8%) samples, including 78/280 (27.8%) with methicillin-susceptible S. aureus (MSSA) and 11/280 (3.9%) with methicillin-resistant S. aureus (MRSA). The highest proportion of S. aureus-positive samples within a site was 70.4%, while that of MRSA was 11.1%; MRSA was not detected at 3/10 sites. The equipment most frequently colonized with MRSA were crawl tubes (15.0%), followed by spring riders (11.1%) and slide edges (10.5%).

The investigators also obtained 18 environmental samples from each of 16 fitness facilities in northeastern Ohio and found an overall S. aureus prevalence of 38.2% (110/288). MSSA was detected in 77/288 (26.7%) cultures, while 33/288 (11.5%) cultures yielded MRSA. All types of fitness facilities, including hospital gyms, had a similar prevalence of contamination with S. aureus, but community gyms had the highest prevalence of MRSA detection.

COMMENTARY

While much of the community acquisition of these organisms is believed to occur as the result of direct human-to-human contact, these results illustrate environmental sources for potential acquisition of both MSSA and MRSA in the community. If, indeed, environmental contamination leads to transmission to humans, the results demonstrate the need for improved environmental microbial control — something perhaps more easily accomplished in fitness centers than at playgrounds. How do you routinely decontaminate a child’s crawl tube? The fitness centers also present problems; all equipment types tested were implicated, including, e.g., 10/16 (62.5%) weight balls and 9/16 (56.3%) weight plates.

The Centers for Disease Control and Prevention recommends the following for preventing transmission of S. aureus from the environment:1

  • Use barriers, like a towel or clothing, between your skin and the surface.
  • Shower immediately after activities in which you have direct skin contact with people or shared surfaces or equipment, such as after exercising at a health club.
  • Clean your hands regularly with soap and water or an alcohol-based sanitizer.
  • Keep cuts and scrapes clean and covered with bandages or dressings until healed.

REFERENCE

  1. Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus (MRSA). Athletic Facilities. Available at: https://www.cdc.gov/mrsa/community/environment/athletic-facilities.html. Accessed March 11, 2019.