When Tanner High School football coach Laron White was in high school, he knew it was time to wash his football practice clothes when they could stand up on their own.

But that was years ago when the only thing players worried about was athlete’s foot.

A lot has changed since then – germs, for one.

A once-rare, drug-resistant strain of staphylococcus aureus, known as staph, now appears to cause more than half of all skin infections treated in U.S. emergency rooms, say researchers who documented the super bug’s startling spread in the general population.

It is hitting school locker rooms, gymnasiums, prisons and day-care centers.

Two West Limestone High School football players recently contracted staph infections. One player was treated and cured swiftly. But the other, Tyler McClung, was hospitalized for several days with a serious staph infection on his left shin. It began as a sore on his leg and turned into a painful infection.

McClung was lucky.

Staph infections can be deadly, particularly if they are not identified quickly or they are the drug-resistant type.

In 2004, a student at Athens Middle School died from a staph infection. At first, no one knew what was making Hunter Bauer sick. He was sent to Athens-Limestone Hospital, Huntsville Hospital and Vanderbilt Hospital in Nashville, where the cause of his illness was identified. But doctors could not save him.

According to the study, many victims mistakenly thought they had spider bites that wouldn’t heal, not drug-resistant staph bacteria. Only a decade ago, these germs were hardly ever seen outside of hospitals and nursing homes.

The germ typically thrives in healthcare settings where people have open wounds and tubes. But in recent years, outbreaks have occurred among prisoners, children and athletes, with the germ spreading through skin contact or shared items such as towels.

Dozens of people in Ohio, Kentucky and Vermont recently contracted methicillin-resistant staphylococcus aureus, or MRSA, skin infections from tattoos. Such bacteria are impervious to the penicillin family of drugs long used for treatment.

Doctors also were caught off-guard — most of them unwittingly prescribed medicines that do not work against the bacteria.

“It is time for physicians to realize just how prevalent this is,” said Dr. Gregory Moran of Olive View-UCLA Medical Center, who led the study.

The Center for Disease Control paid for the study, published in Thursday’s New England Journal of Medicine. Several authors have consulted for companies that make antibiotics.

Researchers analyzed all skin infections among adults who went to hospital emergency rooms in 11 U.S. cities in August 2004. Of the 422 cases, 249, or 59 percent, were caused by MRSA.

The proportion of infections due to MRSA ranged from 15 percent to as high as 74 percent in some hospitals.

“This completely matches what our experience at Vanderbilt Children’s Hospital has been,” said Dr. Buddy Creech, an infectious-disease specialist whose hospital was not included in the study. “Usually what we see is a mom or dad brings their child in with what they describe as a spider bite that’s not getting better or a pimple that’s not getting better,” and it turns out to be MRSA.

The good news: MRSA infections contracted outside a hospital are easier to treat. The study found that several antibiotics work against them, including some sulfa drugs that have been around for decades. A separate study in the journal reports the effectiveness of Cubicin, an antibiotic recently approved to treat bloodstream infections and heart inflammation caused by MRSA.

However, doctors need to test skin infections to see what germ is causing them, and to treat each one as if it were MRSA until test results prove otherwise, researchers said.

“We have made a fundamental shift in pediatrics in our area” and now assume that every such case is the drug-resistant type, Creech said.

And, doctors need to lance the wound to get rid of bacteria rather than relying on a drug to do the job.

“The most important treatment is actually draining the pus,” Gorwitz said. Many times that is a cure all by itself, she said.

The study was done in Albuquerque, N.M.; Atlanta; Charlotte, N.C.; Kansas City, Mo.; Los Angeles; Minneapolis; New Orleans; New York; Philadelphia; Phoenix; and Portland, Ore.