Brief overview
- Causes: Infection through direct contact (usually via the hands) with infected persons or contaminated objects.
- Description: Staphylococci are bacteria that are harmless to healthy people. However, some species cause serious infectious diseases.
- Symptoms: Infections of the skin (e.g. skin rashes, abscesses, boils) are common. Pneumonia, endocarditis, bone inflammation, joint inflammation and blood poisoning, as well as food poisoning and toxic shock syndrome are also possible.
- Prognosis: Staphylococci are generally harmless for healthy people. However, some species can cause infections in certain people at risk, which in severe cases can be fatal if left untreated. With timely treatment, the prognosis is good.
- Treatment: Mild skin infections are usually treated by the doctor with local antibiotics (e.g. ointments, gels). For severe infections, antibiotics (usually penicillin) are used in the form of tablets or as an infusion via the vein.
- Diagnosis: The doctor makes a reliable diagnosis by taking a sample of infected material (e.g. skin swab of pus and wound fluid), which is examined in the laboratory.
How do you get staphylococci?
Staphylococci are part of the natural flora of the skin and mucous membranes. The main reservoir for staphylococci is therefore humans themselves. Normally, the bacteria are harmless to healthy people, but under certain circumstances (e.g. in immunocompromised people) they can lead to infections in the body.
The bacteria usually enter the body via wounds. Transmission usually takes place through direct contact (smear or contact infection) with infected persons (mainly through skin contact via the hands), but also through contaminated objects.
Staphylococci grow best at temperatures between 30 and 37 degrees Celsius. The bacteria survive for several days at room temperature. They are very resistant to environmental influences and survive for a relatively long time on various surfaces. This is why staphylococci are easily transmitted via door handles, light switches or in the kitchen (e.g. kitchen sink).
Although the pathogens die during the preparation of food, the heat-stable toxins they produce (enterotoxins) often survive the cooking temperatures and sometimes cause food poisoning.
Infection via medical instruments (nosocomial infection) such as venous cannulas or venous catheters is also possible. These are used in hospitals, surgeries or nursing homes, for example, to take blood or administer medication.
Transmission routes at a glance
- Staphylococci are usually transmitted via skin contact (especially via skin wounds).
- Indirect transmission occurs via everyday objects or medical instruments (e.g. venous catheters).
- Contact with farm animals that carry the bacterium (especially at the teat canal in cows) may also lead to infection.
- Contaminated food that is touched and/or consumed is another possible cause of a staphylococcal infection.
Who is particularly affected?
People with a weakened immune system, such as older people, newborns, babies or breastfeeding mothers, as well as chronically ill people (e.g. cancer patients, diabetics, dialysis patients) are often affected by staphylococcal infections.
In addition, people who work in the healthcare sector, people with extensive infectious skin diseases and drug addicts are often particularly heavily colonized with staphylococci and therefore have a higher risk of infection.
What is staphylococcus?
The bacteria usually infect people with a weakened immune system (e.g. very young, very old, weakened or chronically ill people). Their immune system is often unable to fight off the pathogens. The bacteria then multiply rapidly in the body and trigger various illnesses (e.g. purulent skin rashes, food poisoning, pneumonia, blood poisoning).
As staphylococci are extremely robust, it is difficult to render them harmless. They quickly develop resistance to antibiotics (i.e. they are insensitive to the drugs) by changing their genetic structure. This is how they ensure their survival.
Infection with staphylococci is possible through many different species and subtypes. The best known and most common types of staphylococci include
- Staphylococcus aureus
- Staphylococcus epidermidis
Staphylococcus aureus
Staphylococcus aureus is also frequently found on the skin of healthy people: The bacterium is found in the nose of around 30 percent of healthy adults and on the skin of around 15 to 20 percent.
Some strains of Staphylococcus aureus are able to produce toxins. If these enter the organism, they can cause life-threatening illnesses.
The most common diseases caused by Staphylococcus aureus include
- Purulent skin infections (e.g. boils on the face)
- Foreign body infections
- Blood poisoning (sepsis)
- Inflammation of the inner lining of the heart (endocarditis)
- Infections of the heart valves
- Pneumonia (inflammation of the lungs)
- Bone infections (osteomyelitis)
- Joint inflammation (arthritis)
- Abscesses in joints, kidneys, central nervous system (CNS) and on the skin
- Diseases caused by bacterial toxins: Lyell syndrome or scalded skin syndrome, toxic shock syndrome (TSS) and food poisoning (gastrointestinal toxicosis)
As Staphylococcus aureus is very infectious and often resistant to common antibiotics, it is one of the most widespread and dangerous pathogens for humans.
Staphylococcus epidermidis
What are the symptoms of a staphylococcal infection?
Staphylococci are capable of causing numerous diseases and therefore a variety of symptoms. The symptoms vary depending on which type of staphylococcus infects the body.
Skin infections
An infection with Staphylococcus epidermidis usually results in mild and localized infections in which the bacteria only infect the skin around the site where they have penetrated. The mucous membranes such as the nasal and pharyngeal mucosa and the conjunctiva of the eye are also at risk of being infected by staphylococci (or streptococci). The eye, for example, secretes purulent, yellowish mucus when infected. Both eyes are usually affected.
In some cases, staphylococci also lead to pneumonia with chest pain and shortness of breath, as well as inflammation of the inner lining of the heart (endocarditis) with palpitations, night sweats and fever.
Boils (inflammation of the hair root) or abscesses (tissue cavity filled with pus) are also sometimes caused by a staphylococcal infection. Staphylococci often infect people with pre-existing skin conditions such as atopic dermatitis and worsen the existing symptoms.
Most skin infections caused by staphylococci are very contagious.
Infections caused by foreign bodies
The greatest danger of the otherwise harmless bacterium Staphylococcus epidermidis lies in its ability to colonize artificial (usually medical) objects inserted into the body, such as catheters, drainage tubes, artificial heart valves, implants or joints. The resulting infection is also known as a foreign body infection, which can have life-threatening consequences. People with weakened immune systems and those being treated in hospital are particularly at risk.
Bone infections
Infections of the bones and bone marrow (osteomyelitis) with staphylococci, for example through pressure sores or foot ulcers in diabetics or through open fractures and surgical wounds, are also possible. This usually results in severe pain in the affected bones or joints, a general feeling of illness and fatigue.
Some staphylococci (especially Staphylococcus aureus) produce bacterial toxins that can sometimes cause life-threatening illnesses in the body. Particularly dangerous for those affected are
Lyell syndrome (also known as scalded skin syndrome)
This is an acute detachment of the epidermis with painful blistering (“scalded skin syndrome”). Newborns and children are most frequently affected.
Toxic shock syndrome
Toxic shock syndrome (TSS) is triggered by staphylococcal or, more rarely, streptococcal toxins (Staphylococcus aureus and Streptococcus pyogenes). Symptoms include fever, headache, skin rash, severe drop in blood pressure due to shock, dysfunction of the internal organs (liver, kidneys, heart, lungs) and even multi-organ failure. In women, the syndrome may be exacerbated by the use of highly absorbent tampons and menstrual cups.
With these diseases, the state of health of those affected usually deteriorates suddenly. If left untreated, they are often fatal.
Food poisoning
Blood poisoning
One of the most serious consequences of an infection with staphylococci in the blood is blood poisoning (sepsis). This is an inflammatory reaction of the body that affects the entire organism via the blood. The immune system tries to defend itself against the bacteria. However, the body’s own defense reaction not only damages the pathogens, but also its own tissue and organs such as the heart and kidneys.
Symptoms of blood poisoning include rapid breathing, rapid pulse, fever, pain and low blood pressure or even shock.
Other possible diseases and symptoms caused by staphylococci are
- Soft tissue infections (such as connective tissue, muscles and fatty tissue) caused by Staphylococcus pyogenes
- Bladder infections caused by Staphylococcus saprophyticus (the pathogen is usually detectable in urine)
- Infections of wounds, bones or joints caused by Staphylococcus haemolyticus
- Infections of the skin or heart valves caused by Staphylococcus lugdunensis
Is a staphylococcal infection dangerous?
However, with timely diagnosis and treatment, the prognosis is good. Treatment may be more protracted if the bacteria are resistant to the antibiotic used.
How does a staphylococcal infection progress?
It usually takes around four to six days for the first symptoms to appear after a staphylococcal infection (incubation period). Sometimes, however, it can take several weeks before the infection breaks out.
In contrast, the incubation period for food poisoning is much shorter: the first symptoms usually appear within two to four hours after the affected person has ingested the contaminated food. In most cases, food poisoning heals on its own without treatment after around twelve hours.
How long are you contagious?
Doctors do not know exactly how long a person with a staphylococcal infection is contagious. However, people are particularly contagious while they have acute symptoms, i.e. for the duration of their symptoms.
In some cases, however, people at risk (e.g. with a weakened immune system) are also infected by healthy people who are colonized with staphylococci and have no symptoms.
How is a staphylococcal infection treated?
Antibiotics
However, if the staphylococcal infection is persistent or if local therapy does not have the desired effect, the doctor will treat it with oral antibiotics in the form of tablets or juices (for children). In severe cases, the antibiotic is administered by injection or infusion directly into the vein.
The drug of choice is penicillin (e.g. flucloxacillin, dicloxacillin or oxacillin). For targeted treatment with antibiotics, laboratory tests are carried out to determine which agent is suitable for the pathogen in question. The doctor often combines treatment with oral and local antibiotics to accelerate the healing process.
MRSA
Some staphylococci are insensitive (resistant) to certain antibiotics: They are able to produce a substance that renders penicillin ineffective. Multi-resistant strains such as methicillin-resistant Staphylococcus aureus (MRSA) pose a particular challenge here.
This is difficult to treat due to its insensitivity to many antibiotic drug classes. In such cases, the doctor resorts to so-called reserve antibiotics. These are not used in the conventional treatment of bacterial infections in order to avoid resistance.
When treating with antibiotics, it is important to take them long enough (even if improvement occurs beforehand) to prevent recurrence and resistance. In the case of a mild infection (e.g. urinary tract infection), it is sometimes sufficient to take the medication for just one day. In the case of severe infections with staphylococci, however, it is often necessary to take antibiotics for several weeks.
Please follow your doctor’s instructions exactly and take the antibiotic for as long as prescribed!
Home remedies
Certain household remedies and medicinal plants such as St. John’s wort oil for external use are said to help against skin infections. St. John’s wort is said to have an anti-inflammatory, antibacterial and wound-healing effect.
Teas (aqueous extracts) made from camomile flowers, witch hazel leaves/bark, marigold flowers, yarrow and echinacea, which are cooled and applied as a wash or compress, are also said to be suitable for disinfecting wounds. Some people also swear by aqueous chestnut leaf extract (tea) for application against the formation of staphylococcal toxins.
How does the doctor make the diagnosis?
Lighter staphylococcal infections of the skin are usually diagnosed by the doctor on the basis of their appearance (visual diagnosis). In the case of deeper infections or if conventional antibiotics are not effective, it is necessary for the doctor to carry out a bacteriological examination.
To do this, he takes a swab of pus and wound fluid on the skin at the edge of the wound using a sterile swab (swab sample). If there is pus inside the tissue (e.g. in the case of abscesses), he takes a sample using a cannula or syringe, or he removes the entire abscess directly.
In the case of infections that affect the whole body (systemic infections), the doctor may take a culture of blood or infected body fluids to detect the bacteria.
In the case of food poisoning, it is often not possible to detect the staphylococci themselves. Instead, the toxins (enterotoxins) produced by the staphylococci can be detected.
The doctor then sends the sample to a laboratory where the pathogen is examined microbiologically and determined. This enables the doctor to determine the exact type of bacteria and initiate targeted treatment.
Multi-resistant pathogens such as MRSA must be reported. This means that the doctor must inform the public health department if he has detected such a pathogen in his patient.
How can a staphylococcal infection be prevented?
As staphylococci are very resistant to external environmental influences and usually survive for several days on surfaces, it is particularly important to ensure sufficient hygiene. Observe the following hygiene rules:
- Wash and/or disinfect your hands thoroughly and regularly.
- Clean door handles, light switches, remote controls, smartphones and kitchen surfaces regularly with antibacterial cleaning agents.
- Wash your towels and comforter covers at a minimum of 60 degrees Celsius and change them frequently.
- Do not leave cooked meals at room temperature for more than two hours. Cheese, meat and other perishable foods should be stored in the refrigerator.
- Clean and disinfect your refrigerator (especially the inside!) regularly.
