Courson, the head athletic trainer at the University of Georgia, wasn't taking any chances. The infected player was immediately prescribed doxycycline and a culture of the wound was sent for analysis. The lab results confirmed what Courson had feared-that this was one more case of the inscrutable strain of bacteria that appears to have found its insidious way from the hospital to the locker room.

Wound care specialists, particularly those who work in hospital environments, are well aware of the devastating potential of methicillin-resistant Staphylococcus aureus, which can lead to amputation or even death. But sports medicine experts are only now beginning to realize the risk of MRSA in locker rooms, gyms, or other athletic facilities where the prevalence of abrasions and other minor wounds, the close proximity of bodies, and often less than impeccable hygiene offer a welcoming environment for a bacterium looking for a place to settle down.

Word is spreading quickly, however, in large part because of MRSA outbreaks involving well-known athletes. A Feb. 28 Sports Illustrated special report listed Junior Seau of the Miami Dolphins, Ben Taylor of the Cleveland Browns, Rashad Anderson of the University of Connecticut basketball team, and five unnamed members of the St. Louis Rams as having been affected. And although all of those players recovered, the report also offered the sobering story of Ricky Lannetti, a wide receiver for Lycoming College in Williamsport, PA, who died in December 2003 of an MRSA infection that developed from what he initially thought was a pimple.

Shortly after the publication of the SI report, the National Athletic Trainers Association drew more attention to the issue by releasing a statement that includes recommendations for prevention (see table). And although most of the recommendations seem like common sense, Courson said educating athletes on the importance of hygiene remains a challenge.

"I've noticed a lot of athletes don't like to shower in the locker room," said Courson, who has seen six cases of MRSA at the University of Georgia in the last two years. "They say they'll shower at home, but things come up, and by the time they get home it's four hours later."

The eight cases of MRSA in the aforementioned five Rams players, documented by researchers from the Centers for Disease Control in the Feb. 3 issue of the New England Journal of Medicine, all developed from turf burn sites.

In the November issue of Clinical Infectious Diseases, researchers from the Connecticut Department of Public Health also found that turf burn was associated with a high relative risk of MRSA in a retrospective cohort study of 100 football players at Sacred Heart University in Fairfield, CT.

NATA recommendations for preventing MRSA

- Keep hands clean by washing thoroughly with soap and warm water or using an alcohol-based hand sanitizer routinely.

- Encourage immediate showering following activity.

- Avoid use of whirlpools or common tubs.

- Discourage sharing of towels, razors, and daily athletic gear.

- Properly wash athletic gear and towels after each use.

- Maintain clean facilities and equipment.

- Administer or seek proper first aid.

- Clean and cover skin lesions appropriately before participation.

- Inform or refer to appropriate healthcare personnel for all active skin lesions and lesions that do not respond to initial therapy.