Staphylococcal infections, also known as Staph infections, are common skin infections caused by a type of bacteria known as Staphylococcus. Staphylococcus is highly infectious and can be spread through skin-to-skin contact, such as sharing items such as towels, and droplets passed from coughs and sneeze. These infections are hard to prevent, as it is normal to have Staphylococcal bacteria on the skin surface, such as armpits and the nose, which are harmless (commensal). However, when they get into the skin through a cut, they can cause infection and symptoms such as blisters and bumps on the skin. It’s believed that one in three people have Staphylococcal bacteria in their noses, its preferred niche, and two in every 100 people will carry a type of Staphylococcal bacteria known as Methicillin-resistant Staphylococcus aureus (MRSA), which is resistant to antibiotics.
Who gets staphylococcal infections?
Anyone can get a Staphylococcal infection. But those who are more at risk are people with certain underlying health conditions or those taking some medications, such as the following:
- Diabetes (whilst using insulin)
- Kidney failure with dialysis treatment
- Immune system disorders, such as from diseases or chemotherapy
- Transplant patients
- Skin conditions such as eczema, cuts or bites
- Lung disorders like cystic fibrosis
- Recent or current hospital stays
- Wounds or burns
Staphylococcal bacteria can be resistant to treatments such as antibiotics.1 This is due to problems such as antibiotic overuse, which can cause the bacteria to become more tolerant to treatment and, therefore, develop methods of disarming the antibiotics. For example, a type of Staph infection known as Methicillin-Resistant Staphylococcus aureus has historically been seen more commonly in healthcare settings than in the community.2 This is because areas such as hospitals are more enclosed and densely populated, containing more vulnerable patients.
Certain regions throughout the world have a higher prevalence of Staph infections, such as in parts of Asia, including Hong Kong and Korea. This can be explained by the higher populations in these areas, as well as insufficient hygiene measures, lack of health resources, and poor testing for antibiotic resistance.3
What are the symptoms of staphylococcal infections?
The infographic below shows some of the most common skin signs and symptoms of Staph infections:
Image source: Parr-Reid S. Canva.
If you are experiencing any of the symptoms listed above, it is important you speak to your healthcare provider as soon as possible to get support. If visiting your healthcare provider causes stress, it can be helpful to take a loved one with you whilst observing mask-wearing and social distancing to prevent the spread of any possible infection.
Where on the body can staph infections be found?
Most commonly, Staph infections reside in the skin on the face and around the mouth and nose. The following list gives some other Staph infection sites:
- The chest area and breasts (e.g., from breastfeeding) – causing swelling and pus-filled blisters
- The digestive system (from food) – causing sickness and diarrhoea
- The bones – causing pain and swelling
- The lungs and heart – causing pneumonia and heart failure
- Blood–causing blood poisoning via blood infection (bacteraemia)
When bacteria such as Staphylococcal bacteria enter the bloodstream, this is very serious. Blood poisoning can occur, known as sepsis. The presence of bacteria in the blood can trigger a process known as septic shock, which can be fatal. This is where the immune system’s inflammatory response to the bacteria causes blood pressure to drop significantly. This is why severe or persistent symptoms must be evaluated by your healthcare provider so that these complications can be avoided.
What are the causes of staphylococcal infections?
Staph infections can originate in several ways. Some of the common causes of Staph infections are listed below:
- Unclean household items that are shared, like pillowcases and towels
- Contact sports where bacteria are transferred
- Contaminated food that is not prepared hygienically (it won't necessarily taste bad/different!)
How are staphylococcal infections diagnosed?
When diagnosing a Staphylococcal infection, your healthcare provider will usually do some or all of the following three things:
- Conduct a physical exam of your skin, noting any reddened areas, bumps or sores and identifying if they are separate from any previously diagnosed skin condition
- Take a sample of nasal secretion, urine, blood or skin to try and find out which bacteria are present and if Staph infection can be identified
- Study the heart using an echocardiogram, which can help to see if your heart has also been infected by Staphylococcus bacteria
How are staphylococcal infections treated?
Treating Staph infections typically involves your healthcare provider prescribing you antibiotics, for example, Oxacillin. Sometimes, stronger antibiotics like Vancomycin are needed if the infection is resistant to commonly prescribed antimicrobials. These antibiotics can either be given by the mouth or via an injection into a vein (intravenous). When taking antibiotics, it is vital to stick to the administration schedule to ensure they are effective and no resistance occurs.3
Sometimes, if the skin is badly affected and there is a build-up of fluid under the surface, your healthcare provider may drain and clean it to help with the swelling and discomfort. They may also remove any objects that carry the infection, such as a cardiac pacemaker or a urinary catheter tube.
Preventing staphylococcal infections
There are several key ways in which you can prevent the spread of Staph infections both in the home and in public places such as schools. The infographic below shows some of these key methods for prevention of Staph infections:4,5
Image source: Parr-Reid S. Canva.
Staphylococcal infections are contagious bacterial infections that mainly affect the skin but can cause damage to other organs, such as the heart, lungs, and digestive system. They can affect anyone, and you can be infected more than once. Those more at risk include people with underlying health conditions such as HIV or diabetes, as well as weakened immune systems. These infections are generally passed through skin-to-skin contact or sharing items such as towels. Common symptoms include boils, swelling and redness of the skin, sickness, diarrhoea, and inflammation of the chest area and breasts. Methods of infection can include poor food hygiene, contact sports and contaminated medical devices such as catheters. Staph infections are normally diagnosed by taking a skin sample or a sample of blood or urine. These infections are treated with antibiotics such as Oxacillin or in the case of antibiotic resistance developing, Vancomycin. Key methods of prevention for Staph infections include the practice of proper hygiene measures, such as hand-washing, proper handling of foods and cooking practices, regular washing of items such as towels, and the avoidance of sharing such items. If a person is infected, it is important that they practise good hygiene and keep a distance from others.
- Huang YC and Chen CJ. New epidemiology of Staphylococcus aureus infection in Asia. Clin Microbiol Infect 2014;20(7): 605–623. https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)61146-0/fulltext
- Lim WW, Wu Peng, Bond HS, Wong JY, Ni K, Seto WH, Jit M and Cowling BJ. Determinants of MRSA prevalence in the Asia Pacific Region: a systematic review and meta-analysis. J Glob Antimicrob Resist 2019;16: 17–27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658325/
- Khanal A, Sulochan GC, Amrit G, Khanal A, Estrada R, Ghimire R and Panthee S. Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis. Int J Infect Dis 2021;103: 48–55. https://www.sciencedirect.com/science/article/pii/S1201971220324632
- Creech CB, Al-Zubeidi DN and Fritz SA. Prevention of Recurrent Staphylococcal Skin Infections. Infect Dis Clin North Am 2015;29(3): 429–464. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552962/
- Kalu IC, Kao CM and Fritz SA. Management and Prevention of Staphylococcus aureus Infections in Children. Infect Dis Clin North Am 2022;36(1): 73–100. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901217/