Epidemiology of skin infections in men's wrestling: Analysis of 2009-2010 through 2013-2014 National Collegiate Athletic Association surveillance data

Abstract

Context: Our knowledge of the current epidemiology of skin infections among wrestlers is limited. Objective: To analyze and report the epidemiology of skin infections among National Collegiate Athletic Association (NCAA) men's wrestling student-athletes during the 2009-2010 through 2013-2014 academic years. Design: Descriptive epidemiology study. Setting: Aggregate skin infection and exposure data collected by the NCAA Injury Surveillance Program. Patients or Other Participants: Collegiate men's wrestling student-athletes. Main Outcome Measure(s): All viral, bacterial, or fungal skin infections reported by athletic trainers at 17 NCAA programs were analyzed, providing 35 team-seasons of data. Skin infection rates per 10 000 athlete-exposures (AEs), rate ratios, skin infection proportions, and skin infection proportion ratios were calculated. Results: The athletic trainers reported 112 skin infections contracted by 87 student-athletes across 78 720 AEs. The overall skin infection rate was 14.23/10 000 AEs (95% confidence interval [CI] = 11.59, 16.86). Of the skin infections identified, 22.3% (n = 25) were recurrent skin infections. Most skin infections (65.2%) were attributable to 5 team-seasons (range, 11-19 infections). Most skin infections occurred during the regular season (n = 76, 67.9%), were identified during practice (n = 100, 89.3%), and resulted in ≥24 hours' time loss (n = 83, 74.1%). The rate for viral skin infections was 1.72 times the rate for bacterial skin infections (95% CI = 1.09, 2.72) and 2.08 times the rate for fungal skin infections (95% CI = 1.28, 3.39). Fungal skin infections more often resulted in time loss <24 hours compared with all other skin infections (75.0% versus 12.5%; infection proportion ratio = 6.00; 95% CI = 3.30, 10.92). Conclusions: Our findings highlight the contagiousness of skin infections and suggest that skin infection rates may be attributable to high incidences among particular teams.