Staph: A-to-Z Guide from Diagnosis to Treatment to Prevention

Introduction to staph:

Staph infections are very common. The bacteria look like innocent clusters of grapes under the microscope.

Little girl in sunglasses. Staph is a common skin infection.

What is staph?

Staphylococcus bacteria surround us! They are often found on the surface of healthy people’s skin. Infection occurs if they enter the skin, or enter the body through another route.

There are many species of Staph bacteria. They cause a wide variety of illnesses in children, ranging from very mild skin infections to devastating toxic shock syndrome.

Skin infections are especially common and include impetigo, conjunctivitis, cellulitis, acne, boils, styes, and infected wounds or hangnails. Staph can be associated with mild blocked tear ducts in newborns. Staph scalded skin syndrome, though, is a severe skin disease caused by the bacteria.
Staphylococcus can cause infections in the ears, nose, and throat. And it can cause swimmer’s ear, an infection in the ear canal.

Staph infections also occur in lymph nodes. Staph blood infections can lead to many other areas of infection including pneumonia, infective arthritis, bone infections, and even meningitis.
Staph food poisoning is one of the most common types of food poisoning.

Who gets it?

Most or all children get some form of Staph infection. Those with an underlying chronic disease, such as diabetes, or those with indwelling foreign bodies, such as shunts, catheters, or artificial joints, are at the highest risk.

Staph food poisoning comes from eating foods contaminated by the bacteria. Staph usually gets into the food from food handlers with infected eyes, fingers, pimples, boils, rashes, or nasal secretions. When Staph is introduced into prepared foods and not followed immediately by cooking or refrigeration, the bacteria multiply and produce a toxin that will not be destroyed by cooking. The ideal temperature for Staph to grow is about body temperature.

The most commonly affected foods are sandwiches, sliced ham, poultry, or other meats, potato salads, egg salads, salad dressings, cream-filled pastries, and custards.

What are the symptoms?

The symptoms of a Staph infection vary depending on the location and severity of the infection. (See individual conditions such as conjunctivitis or impetigo for possible symptoms.) It may produce pus wherever it appears.

Staph food poisoning is dramatic in that it begins quickly after eating the offending food — within 8 hours, usually within 4 hours, often within 30 minutes. Children with Staph will have sudden severe nausea, vomiting, and cramps, often accompanied by diarrhea. There is usually no significant fever, in fact the temperature often drops. And the person feels miserable!

If you’ve ever lain on the floor for several hours wishing you were dead, suddenly sick after eating a meal, Staph was a likely cause.

The rapid onset, presence of vomiting, and absence of significant fever make it possible to distinguish Staph from other sources of food poisoning. (Clostridium, for example, takes longer to make you sick and rarely includes vomiting; Salmonella also takes longer and usually includes a fever).

Is it contagious?

Staph infections can be spread from person to person by direct contact.

How long does it last?

Food poisoning usually lasts for a day or two. Other Staph infections have widely varying lengths.

How is it diagnosed?

Staphylococcus can be identified with cultures or other diagnostic tests of the part of the body infected. Sometimes the diagnosis is clear from the history and physical exam.

How is it treated?

Treatment depends on the location and severity of the infection. Most Staph infections require some sort of antibiotics. These might be antibiotic creams, eye drops, or oral or IV antibiotics depending on the location. These must be chosen carefully, as many Staph are resistant to many antibiotics.

For Staph food poisoning, antibiotics are not helpful.

How can it be prevented?

Staphylococcus bacteria are so widespread, that infection can be difficult to prevent. Some infections can sometimes be prevented by observing “contact” precautions, including excellent hand washing.
Staph food poisoning can be prevented by not allowing cooked or prepared foods to sit at room temperature for longer than 2 to 4 hours. As far as possible, reduce the time from food preparation to either refrigerating or eating the food.

People with open sores on the hands or face, or with a thick creamy discharge from the nose, should not be involved in preparing food.

Related concepts:

Staphylococcus aureus, Staphylococcal infections

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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