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Staph infections - hospital

"Staph" (pronounced staff) is short for Staphylococcus. Staph is a germ (bacteria) that can cause infections in any part of the body, but most are skin infections. Staph can infect openings in the skin, like scratches, pimples, or skin cysts. Anyone can get a staph infection.

Hospital patients can get staph infections of the skin:

  • Anywhere a catheter or tube enters the body. This includes chest tubes, urinary catheters, IVs, or central lines
  • In surgical wounds, pressure sores (also called bed sores), or foot ulcers

Once the staph germ enters the body, it can spread to bones, joints, and the blood. It can also spread to any organ, such as the lungs, heart, or brain.

Staph can also spread from one person to another.

Staph Infections in the Hospital

Staph germs are mostly spread by skin-to-skin contact (touching). A doctor, nurse, other health care provider, or even visitors may have staph germs on their body and then spread them to a patient. This can happen when:

  • A provider carries staph on the skin as normal bacteria.
  • A doctor, nurse, other provider, or visitor touches a person who has a staph infection.
  • A person 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.

What are Risk Factors for Staph Infection?

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 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 illegal drugs
  • Living with or having close contact with a person who has staph
  • Being on kidney dialysis

How do you Know if you Have a Staph Infection?

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, or sputum (phlegm). The sample is sent to the lab for testing.

Preventing Staph Infection in Hospitals

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.

References

Calfee DP. Prevention and control of health care-associated infections. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 282.

Chambers HF. Staphylococcal infections. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 288.

Huskins WC, Sammons JS, Coffin SE. Health care-associated infections. In: Cherry JD, Harrison GJ, Kaplan SL, et al., eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 243.

Maki, DG, Tsigrelis C. Nosocomial infection in the intensive care unit. In: Parillo JE, Dellinger RP, eds. Critical Care Medicine: Principles of Diagnosis and Management in the Adult. 4th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 50.

Rupp ME, Fey PD. Staphylococcus epidermidis and other coagulase-negative staphylococci. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2014:chap 197.

Update Date 11/1/2015

Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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