Staph Skin Infections

A growing number of healthy people are developing staph infections, typically on their skin. Some staph bacteria, including MRSA (short for methicillin-resistant Staphylococcus aureus), are resistant to antibiotics, making these infections difficult to cure.

Staph bacteria are commonly found on the skin or in the noses of even healthy individuals. Most of the time, staph bacteria cause no problems, or only minor infections. According to the Centers for Disease Control and Prevention (CDC), in 2004 approximately 79 million people in the U.S. had S. aureus and four million had MRSA living in their noses.

Lenox Hill Hospital dermatologist Doris Day says staph cases tend to come in waves. “I see a whole bunch of infections, and then there’s a lull,” Day told Healthline.

Day said the overuse of antibiotics without proper work up or follow up may be fueling a rise in newer and more resistant staph infections. “I see patients on antibiotics for another infection, and yet they still come in with a staph skin problem,” she said.

But she believes the increase in cases she's observed is more often the result of stopping antibiotics too soon. “This increases bacterial resistance and the likelihood of reinfection. It’s also important to do a culture to adequately cover for the particular strain of staph, and this may require more than one antibiotic,” Day added.

How Serious Is the Problem?

The CDC Active Bacterial Core surveillance (ABCs) program monitors diseases like MRSA. The CDC has not published prevalence data on community-based MSRA in a number of years, but has stated that rates of MRSA infections have risen rapidly in the past 10 years.

In 2005, there were about 14 million outpatient visits to doctors’ offices and emergency clinics for suspected S. aureus skin and soft tissue infections in the U.S., according to a study published in the Annals of Internal Medicine.

Staph infections can turn lethal if the bacteria enter the bloodstream. “If you have fever, chills, vomiting, change in mental status—all of these are signs of a serious infection,” Day said. “Most of all, if you see expanding red circles, or lines of red going up or down from the wound, that’s a blood infection and you need to get to the emergency room right away.”

Could I Be at Risk?

The risk of getting a staph infection varies depending on, among other things, the strength of your immune system, the types of sports you play, your age, and any other health problems you have.

The most common risk factors are recent antibiotic use, recent hospitalization, frequent needle sticks, and playing contact sports like wrestling and football. And people who have had previous staph infections are more likely to develop them again.  

Depending on your age, staph germs can cause different types of infections.

In adolescence through age 45 or 50, the most common type of infection is a boil—the virulent infection of a hair follicle or oil gland. Boils often develop under the arms, around the groin, or on the buttocks.

Children may also get a staph skin infection called impetigo. It is a contagious, painful rash around the nose and mouth that forms fluid-oozing blisters.

Even newborns can get a staph infection called Staphylococcal scalded skin syndrome. The condition results in fever and scalp rash, caused by toxins from a staph infection in the mother during pregnancy.

Cellulitis, an infection of the deeper layers of the skin, often occurs in older people. It causes redness, swelling, wound heat, and sores. Areas of oozing discharge may develop, too. Cellulitis occurs most often in the lower legs and feet, and it is more likely to develop into a serious blood infection than other types of staph skin infections.

Day said that as people age and produce less collagen in their skin, the skin thins, leaving it more vulnerable to deep tissue infections. And patients with certain preexisting conditions are at higher risk. “People with psoriasis or eczema are more prone because they may have staph colonies living in and around the lesions,” Day explained.

How Are Staph Infections Treated?

Antibiotics are the primary treatment for staph skin infections. Your doctor may run cultures to learn what type of staph bacteria it is and which medicines will work best (or won't work at all).

If it is a boil, your doctor may need to make an incision to drain the fluid. This helps the wound heal, but you'll need to take extra care to keep the area covered with a dry, sterile bandage to keep the bacteria from spreading.

“If a patient has recurrent staph infections, the culprit may be a bacterial colony in areas like the ears or nose,” Day said. If a patient has staph bacteria living in his or her nose, it should be identified and treated before surgery, because if it spreads to the surgical site it could cause serious complications.

If staph is found during a nasal swab test, Day treats the bacteria with ear drops or a nasal-spray antibiotic.

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