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Staphylococci: Infections, Symptoms and Treatment

Staphylococci are spherical bacteria commonly found on skin and mucous membranes. They can be harmless or cause serious infections depending on circumstances.

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Things worth knowing about "Staphylococci"

Staphylococci are spherical bacteria commonly found on skin and mucous membranes. They can be harmless or cause serious infections depending on circumstances.

What are Staphylococci?

Staphylococci (genus: Staphylococcus) are spherical, gram-positive bacteria that cluster together in grape-like formations. They are part of the normal human bacterial flora, commonly colonizing the skin, nasal passages, and mucous membranes without causing disease. However, under certain conditions – such as a weakened immune system or a breach in the skin barrier – they can cause serious infections.

Types of Staphylococci

There are more than 40 known species of staphylococci. The most medically significant include:

Staphylococcus aureus: The most common disease-causing species. It can cause a wide range of infections, from minor skin conditions to life-threatening illnesses such as sepsis and pneumonia.
Staphylococcus epidermidis: Commonly found on the skin; harmless in healthy individuals but can cause infections in immunocompromised patients or via medical devices such as catheters.
Staphylococcus saprophyticus: A common cause of urinary tract infections, particularly in young women.

Causes and Transmission

Staphylococci are primarily transmitted through direct contact. Common routes of transmission include:

Direct skin-to-skin contact with an infected person
Contact with contaminated surfaces or objects
Respiratory droplets
Contaminated food (staphylococcal enterotoxins)
Medical procedures, catheters, or implants (hospital-acquired infections)

Symptoms

The symptoms of a staphylococcal infection depend greatly on the affected area of the body:

Skin and soft tissue: Boils, carbuncles, abscesses, wound infections, impetigo, and Staphylococcal Scalded Skin Syndrome (SSSS)
Respiratory tract: Pneumonia, particularly as a complication following viral infections such as influenza
Bloodstream infection (sepsis): High fever, chills, and circulatory failure – a medical emergency
Infective endocarditis: Inflammation of the inner lining of the heart, often associated with intravenous drug use or cardiac surgery
Food poisoning: Nausea, vomiting, and diarrhea – typically occurring within 1 to 6 hours of consuming contaminated food
Urinary tract infections: Burning sensation during urination, frequent urge to urinate

Diagnosis

Diagnosis of a staphylococcal infection is made through:

Microbiological cultures: Swab, blood, urine, or wound cultures to identify the causative organism
Antibiogram (susceptibility testing): Testing the pathogen for antibiotic resistance – particularly important for detecting MRSA (Methicillin-resistant Staphylococcus aureus)
Imaging: Ultrasound, CT, or MRI for deep tissue infections or endocarditis
Echocardiography: Cardiac ultrasound when endocarditis is suspected

Treatment

Treatment depends on the type and severity of the infection as well as the resistance profile of the pathogen:

Antibiotics: For susceptible Staphylococcus aureus strains, penicillinase-resistant penicillins (e.g., flucloxacillin) or cephalosporins are used. For MRSA, reserve antibiotics such as vancomycin or linezolid are required.
Surgical drainage: Abscesses often need to be surgically incised and drained, as antibiotics alone are frequently insufficient.
Removal of foreign bodies: Infected catheters, implants, or pacemakers may need to be removed.
Supportive care: Severe infections such as sepsis require intensive care management.

MRSA – Methicillin-Resistant Staphylococcus aureus

MRSA is a particularly dangerous form of Staphylococcus aureus that is resistant to most conventional antibiotics. MRSA infections occur frequently in hospitals (hospital-acquired MRSA, HA-MRSA) and in the wider community (community-acquired MRSA, CA-MRSA). Hygiene measures such as regular handwashing, disinfection, and isolation protocols for affected patients are essential to contain its spread.

Prevention

The following measures are recommended to prevent staphylococcal infections:

Regular and thorough handwashing
Proper cleaning and covering of wounds
Avoiding sharing towels, razors, or other personal items
Adherence to hygiene standards in hospitals and care facilities
Safe food preparation and storage practices

References

Robert Koch Institute (RKI): Staphylococci – Infectious Diseases A-Z. www.rki.de (2023)
Lowy, F.D.: Staphylococcus aureus infections. New England Journal of Medicine, 339(8):520-532 (1998)
Tong, S.Y.C. et al.: Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clinical Microbiology Reviews, 28(3):603-661 (2015)

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