Staphylococcus aureus
back to main page
Golden staph (Staphylococcus aureus) is a Gram-positive bacterium belonging to the genus Staphylococcus, which is one of the most common pathogens causing infections of the skin, soft tissues and many internal organs. This microorganism naturally colonizes the skin and mucous membranes of humans – particularly the nasal cavity – without causing symptoms in some people. The problem arises when the bacterium penetrates deeper layers of the skin or enters the bloodstream. It can then cause both local dermatological infections (e.g. boils, abscesses, impetigo) and severe systemic infections such as pneumonia, endocarditis or sepsis.
Staphylococcus aureus – causes
Infection with Staphylococcus aureus most commonly occurs as a result of contact with a person who is a carrier of the bacteria or through direct contact with contaminated objects. It is estimated that 20–30% of the population are persistent carriers of Staphylococcus aureus, mainly in the anterior nasal vestibule.
The most common routes of infection include:
- direct contact with the skin of an infected person,
- contact with contaminated surfaces or objects (e.g., towels, cosmetic tools),
- transfer of bacteria from one’s own skin or nose to a wound,
- hospital-acquired infections, especially in hospitalized patients.
The risk of developing an infection is increased primarily by:
- breaks in the skin barrier (wounds, abrasions, surgical procedures),
- skin conditions involving microdamage to the epidermis (e.g., atopic dermatitis),
- weakened immune system,
- diabetes,
- chronic systemic diseases,
- use of vascular catheters or medical implants.
The bacteria’s ability to produce toxins and enzymes also plays an important role, as these facilitate its penetration into tissues and evasion of the body’s immune response. A modern medical problem is also the occurrence of antibiotic-resistant strains, such as MRSA (Methicillin-Resistant Staphylococcus aureus).
Staphylococcus aureus – how can you become infected
Infection with Staphylococcus aureus most often occurs as a result of direct contact with a person who is a carrier of the bacteria or through contact with surfaces contaminated by the microorganism. This bacterium can colonize the skin and mucous membranes without causing symptoms of disease, which is why many people unknowingly serve as a source of infection for others. The most common site of carriage is the nasal vestibule, but the bacterium can also reside on the facial skin, hands, or in the armpits.
The main routes of transmission include:
- direct contact with the skin of an infected person or a carrier,
- contact with contaminated objects (e.g., towels, bedding, hygiene items),
- autoinoculation, i.e., transfer of bacteria from one’s own skin or nose to a wound or broken skin,
- hospital-acquired infections, especially in people undergoing medical procedures or who are hospitalized.
The risk of infection increases in situations where there is damage to the epidermal barrier, which facilitates the bacteria’s penetration into the deeper layers of the skin. This applies, among others, to:
- cuts and abrasions,
- surgical wounds,
- inflammatory skin conditions,
- procedures that break the continuity of the skin.
In the medical environment particular attention is paid to antibiotic-resistant strains, such as MRSA (Methicillin-Resistant Staphylococcus aureus), which can be transmitted both in healthcare facilities and in the community.
Staphylococcus aureus – where is it found on the skin
Staphylococcus aureus can colonize various body areas, but some sites are particularly prone to the presence of this bacterium. This is due to conditions that favor its multiplication, such as increased skin moisture, the presence of hair follicles, or microdamage to the epidermis.
The most common sites of Staphylococcus aureus on the skin are:
- the area of the nose and the nasal vestibule – the most common site of bacterial carriage,
- the face and chin area, where there is a large number of hair follicles,
- the armpits (axillae),
- the groin,
- the genital areas,
- skin folds, where elevated moisture is maintained.
On the skin the bacterium can cause various forms of infection depending on the depth of the tissues involved. The most commonly observed lesions include:
- folliculitis,
- furuncles and carbuncles,
- skin abscesses,
- impetigo,
- infections of wounds and skin injuries.
Areas of skin exposed to friction, excessive sweating, or frequent minor injuries are particularly susceptible to the development of infection, e.g. during shaving or intense physical activity. For this reason Staphylococcus aureus relatively often causes inflammatory lesions in areas of increased skin moisture and within hair follicles.
In some people the bacterium can reside on the skin for a long time without causing symptoms, but under favorable conditions – e.g. with decreased immune resistance or damage to the epidermis – it can lead to the development of localized or generalized infections.
Staphylococcus aureus – symptoms
The symptoms of Staphylococcus aureus infection are very varied and depend primarily on the location of the infection and the degree of its advancement. Most often the bacterium causes purulent skin lesions.
Typical skin symptoms include:
- furuncles and furunculosis – painful, purulent nodules forming around a hair follicle,
- impetigo – superficial blisters and crusts on the skin, especially in children,
- skin abscesses,
- folliculitis,
- multiple furuncles and carbuncles.
Skin lesions are usually characterized by:
- redness,
- pain/tenderness,
- swelling,
- presence of purulent material.
In more severe cases the bacterium can enter the bloodstream and cause systemic infections such as:
- pneumonia,
- endocarditis,
- osteomyelitis,
- toxic shock syndrome (TSS),
- sepsis.
In the course of a generalized infection, general symptoms may appear, including:
- fever,
- chills,
- weakness,
- rapid heartbeat,
- drop in blood pressure.
In dermatology it is important to differentiate staphylococcal lesions from other skin diseases with a similar clinical presentation, e.g. acne, folliculitis of fungal etiology, or lesions caused by bacteria of the genus Streptococcus.
Staphylococcus aureus – treatment
Treatment of infections caused by Staphylococcus aureus depends on the type of infection, its location, and the bacteria’s susceptibility to antibiotics. For minor skin lesions, therapy often includes topical treatment, whereas more severe infections require systemic therapy.
Basic treatment methods include:
1. Pharmacological treatment
The most commonly used are:
- topical antibiotics (e.g., mupirocin, fusidic acid),
- oral or intravenous antibiotics for extensive infections,
- anti-inflammatory and analgesic drugs.
When infection with an MRSA strain is suspected, appropriately selected antibiotic therapy must be used after performing an antibiogram, i.e., a test determining the bacteria’s susceptibility to specific drugs.
2. Surgical treatment
When abscesses or large inflammatory lesions develop, it may be necessary to:
- incise and drain the abscess,
- surgically clean the wound.
Removal of purulent material often significantly accelerates the healing process.
3. Supportive measures and prevention
Limiting the spread of the bacteria is also important by:
- thorough skin hygiene,
- disinfection of wounds and cuts,
- avoiding sharing towels or cosmetic tools,
- disinfection of medical and cosmetic instruments.
In dermatology and aesthetic medicine particular attention is paid to the prevention of bacterial infections after procedures that disrupt skin integrity. Proper skin disinfection and adherence to aseptic principles minimize the risk of staphylococcal superinfections.
In cases of recurrent skin infections, treatment may also include eradication of bacterial carriage, for example by using antibacterial nasal preparations and specialized antiseptic agents for skin washing.
