Staph infection

Many people have staph bacteria on their skin or in their noses, but most don't get an infection.

But when staph bacteria enters a cut in the skin, it can become infected and possibly develop into a very serious condition.

Over 119,000 people suffered from bloodstream staph infections in 2017 - and nearly 20,000 of those people died. You are at higher risk for a staph infection if you have come in contact with a person with staph, been in a healthcare facility, had surgery, had an invasive medical device such as an IV attached to your skin, or injected drugs such as opioids. Progress has been made to decrease staph infections, but that progress has leveled out in recent years.

Here, you'll learn more details about staph infections, including an overview, treatment and prevention measures. You'll also learn about staph infections that are resistant to antibiotics.

What are Staphylococcal (staph) infections?

Staphylococcus is comprised of over 30 types of bacteria, causing skin and bone infections, food poisoning, pneumonia, toxic shock syndrome and endocarditis (an infection of the endocardium, the inner lining of the heart chambers and valves). Pneumonia is the most common. If the infection gets into the bloodstream, it can lead to sepsis (a life-threatening complication of an infection) or death.

Over half of staph pneumonia is methicillin-resistant staphylococcus aureus (MRSA), and approximately two percent of people chronically carry MRSA. MRSA is a very serious infection and has been labeled a "superbug" because this bacteria has adapted, becoming resistant to antibiotics. This means that one or more antibiotics will not stop the bacteria from multiplying or kill the bacteria, which decreases treatment options. MRSA is fatal in 20-40% of people with the infection. The risk of death is even higher in people with chronic health conditions, those who have had a previous MRSA infection, and people with a positive MRSA blood culture for 12 hours or more.

How do you get a staph infection?

About one-third of people carry staph bacteria on their skin or in their noses, but this doesn't mean they have a staph infection. Bacteria can enter through a break in the skin, which can cause an infection. Staph, including MRSA infections, are transmitted by physical skin contact in community or healthcare settings by kissing, hugging or touching an infected person. It can be transmitted by touching clothing, a towel, door handles, remote control devices, smartphones or athletic equipment that carries the bacteria. It can also spread when food is prepared improperly by someone with a staph infection.

The life of a staph infection can vary from hours to days or weeks on some surfaces. Once you're infected with staph, the infection increases quickly in 24-48 hours with topical skin symptoms involving a few small red areas that look like pimples or boils, accompanied by a fever. Within 72 hours, the red areas increase in size, become painful, and fill they with pus.

People with diabetes, eczema, cancer and vascular and lung disease are more likely to acquire a staph infection. In addition, people with a weakened immune system from human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), chemotherapy or medications that prevent organ rejection are more susceptible to staph infections. People who participate in contact sports, like wrestling or football that involve sharing equipment or heavy skin-to-skin contact with cuts and abrasions, have a higher risk of staph infections. People who live or work in crowded conditions, such as military training camps, childcare centers and jails, are also at greater risk of contracting staph infections.

What are the symptoms of a staph infection?

Staph can infect different layers of the skin and soft tissues. It can develop with:

• Impetigo—a common and highly contagious skin infection with red sores on the face, hands, and feet that can burst and develop crusts that are honey-colored. Impetigo is mainly found in infants and children
• Cellulitis—a common bacterial skin infection that can become serious with swollen, red, painful and warm-to-touch skin, usually on the lower legs, but also occurring on the face, arms and other areas
• Carbuncles—a bacterial infection of hair follicles with painful, pus-filled bumps that form under the skin
• Abscesses or surgical site infections.

The skin infected with staph may be swollen, red and painful. A common complaint by patients with a staph infection is feeling like they have a "spider bite." MRSA can infect the bloodstream, lungs, heart, urine or any area where you recently had surgery.

Symptoms vary depending upon the type of staph infection you have. Severe symptoms include:

• Chest pain
• Shortness of breath
• Cough
• Fatigue
• Headache
• Rash

Bone infection symptoms include:

• Swelling, pain and redness of the affected area
• Fever
• Chills

The symptoms of pneumonia include:

• Chills
• High fever of 103 degrees Fahrenheit or greater
• Cough that does not improve
• Chest pain
• Shortness of breath

Food poisoning symptoms include:

• Nausea
• Vomiting
• Diarrhea
• Fever
• Dehydration (signs include decreased urine output, very dry skin, dizziness, headache and thirst).

How to treat a staph infection

If you think you have a staph infection, cover the affected skin, wash your hands, and contact a healthcare provider before it develops into a more serious infection.

Your provider will review your symptoms, complete a physical exam, and drain the infected lesion if necessary. They'll culture the wound drainage for staph and may order imaging tests, depending on the source of the infection.

In many cases, home remedies can help minor staph infections that only affect the top layer of skin. Keep wounds clean and cover them with bandages to absorb wound drainage. Make sure you wash your hands after caring for the wound to keep from spreading the infection to others. Do not pop, drain or use disinfectants on the affected area.

It's important to disinfect your home to keep the infection from spreading to others. Read labels on disinfectant products at grocery, pharmacy or other retail stores to find the list of germs that they kill, and make sure they work against staph. Clean areas of your home that come into contact with bare skin such as desks, benches, chairs, gym equipment, faucets, remote control devices and light switches.

Your health care provider will decide if you need antibiotics. You may be prescribed antibiotic creams or ointments, or you may need to take an antibiotic by mouth or intravenously (through an IV). The treatment for uncomplicated staph infections is vancomycin every 8-12 hours by mouth or daptomycin by IV once a day. If culture results show the bacteria is methicillin-susceptible staph aureus (MSSA), antibiotic treatment can be changed to nafcillin, oxacillin or cefazolin by mouth. MRSA is resistant to penicillin and cephalosporin. In some cases, treatment with medications either by mouth or IV may last 14 days, and may lead to a staph-negative blood culture in 72 hours. People with deep infection may need IV treatment for more than two weeks.

If the infection progresses and systemic symptoms (such as septicemia, blood poisoning, toxic shock syndrome linked to tampons, wounds or surgery site infections) develop, get worse or do not improve within 48 hours, your health care provider may change your treatment plan. You may be referred to a specialist in infectious diseases, or you may need surgery to drain deep, painful abscesses or to remove medical devices attached to the skin such as IVs at infected sites.

How can staph infections be prevented?

Here are some ways to prevent the spread of staph infections:

• Wash your hands carefully with soap and running water. Scrub for 15 seconds or more, and then dry your hands with a disposable towel. If soap and water are not available, use a hand sanitizer with at least 62% alcohol.
• Don't share personal products, including towels, sheets, clothing, razors or athletic equipment.
• Sanitize linens if you have a sore or cut. Wash towels and bedding on the hottest water setting in a washing machine, and dry them on the hottest setting in the dryer.
• Clean abrasions and cuts. Then apply a sterile, dry bandage to keep wounds from spreading bacteria, especially infected sores with pus.
• Shower after participating in sports using soap and water. Do not share your towel with others.
• Do not prepare food for others if you have a staph infection.
• Stay away from illicit drugs. People who use intravenous drugs have an increased risk of MRSA, hepatitis C and HIV.

If you plan to visit someone with MRSA in the hospital, know that both visitors and health care workers will be required to wear protective garments and follow strict handwashing procedures to keep the infection from spreading.

MRSA has developed from decades of unnecessary antibiotic use. Antibiotics do not work to treat viral infections—yet, they have been prescribed for colds, flu and other viral infections. Antibiotics, even when prescribed appropriately, can contribute to the rise of drug-resistant bacteria because they don't destroy every germ. Bacteria that survive treatment with one antibiotic quickly learn to resist other antibiotics. Both health care providers and patients should take responsibility to use antibiotics only when necessary.

Published on Octopber 18, 2019

References:

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