Staph infections in the hospital

Staph germs are mostly spread by skin-to-skin contact (touching). Health care providers or even visitors may have staph germs on their body and then spread them to a patient. This can happen when:

• A provider or visitor carries staph on the skin as normal bacteria.
• A provider or visitor touches a person who has a staph infection.
• A provider or visitor develops a staph infection at home and brings this germ to the hospital. If the person then touches another person without washing their hands first, the staph germs may spread.

Also, a patient may have a staph infection before coming to the hospital. This can occur without the person even being aware of it.

In a few cases, people can get staph infections by touching clothing, sinks, or other objects that have staph germs on them.

One type of staph germ, called methicillin-resistant Staphylococcus aureus (MRSA), is harder to treat. This is because MRSA is not killed by certain antibiotics used to treat ordinary staph germs.

Many healthy people normally have staph on their skin. Most of the time, it does not cause an infection or symptoms. This is called being colonized with staph. These people are known as staph carriers. They can spread staph to others. Some people colonized with staph develop an actual staph infection that makes them sick.

Common risk factors for developing a serious staph infection are:

• Being in a hospital or other type of care facility for a long time
• Having a weakened immune system or ongoing (chronic) illness
• Having an open cut or sore
• Having a medical device inside your body such as an artificial joint
• Injecting medicines or illegal drugs
• Living with or having close contact with a person who has staph
• Being on kidney dialysis

Any time an area of your skin appears red, swollen, or crusty, a staph infection may be the cause. The only way to know for sure is to have a test called a skin culture. To do the culture, your provider may use a cotton swab to collect a sample from an open wound, skin rash, or skin sore. A sample may also be taken from a wound, blood, sputum (phlegm) or your nose. The sample is sent to the lab for testing.

The best way to prevent the spread of staph for everyone is to keep their hands clean. It is important to wash your hands thoroughly. To do this:

• Wet your hands and wrists, then apply soap.
• Rub your palms, backs of your hands, fingers, and in between your fingers until the soap is bubbly.
• Rinse clean with running water.
• Dry with a clean paper towel.
• Use a paper towel to turn off the faucet.

Alcohol-based gels may also be used if your hands are not visibly dirty.

• These gels should be at least 60% alcohol.
• Use enough gel to wet your hands completely.
• Rub your hands until they are dry.

Ask visitors to wash their hands before they come into your hospital room. They should also wash their hands when they leave your room.

Health care workers and other hospital staff can prevent staph infection by:

• Washing their hands before and after they touch every patient.
• Wearing gloves and other protective clothing when they treat wounds, touch IVs and catheters, and when they handle bodily fluids.
• Using the proper sterile techniques.
• Promptly cleaning up after dressing (bandage) changes, procedures, surgeries, and spills.
• Always using sterile equipment and sterile techniques when taking care of patients and equipment.
• Checking for and promptly reporting any sign of wound infections.

Many hospitals encourage patients to ask their providers if they have washed their hands. As a patient, you have the right to ask.

Calfee DP. Prevention and control of health care-associated infections. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 261.

Centers for Disease Control and Infection website. Clinical overview of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare settings. www.cdc.gov/mrsa/hcp/clinical-overview/?CDC_AAref_Val=https://www.cdc.gov/mrsa/healthcare/index.html. Updated April 12, 2024. Accessed June 18, 2024.

Que YA, Moreillon P. Staphylococcus aureus (including Staphylococcal toxic shock syndrome). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 194.

Updated by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.