How can I prevent the spread of a staph (Staphylococcus) infection and what are the treatment options?

Preventing and Treating Staph Infections

Regular bathing is recommended for preventing staph infection spread, but you should use proper techniques including dilute bleach baths for recurrent infections and avoid sharing personal items that contact skin. 1, 2

Prevention of Staph Infection Spread

Personal Hygiene Measures

• Maintain good personal hygiene with regular bathing and cleaning of hands with soap and water or alcohol-based hand gel, particularly after touching infected skin 1
• Keep draining wounds covered with clean, dry bandages to prevent spread of infection 1, 2
• Dry carefully between skin folds after bathing to prevent bacterial growth 2
• Avoid reusing or sharing personal items (e.g., disposable razors, linens, towels) that have contacted infected skin 1, 2

Bathing Techniques

• For regular prevention: Use warm (not hot) water for bathing 2
• For recurrent infections: Consider dilute bleach baths (¼ cup bleach per ¼ tub or 13 gallons of water) for 15 minutes twice weekly for 3 months 1
• Use separate towels for drying infected areas to prevent spread to other body parts 2

Environmental Hygiene

• Focus cleaning efforts on high-touch surfaces that come into frequent contact with bare skin:
  • Counters, doorknobs, bathtubs, toilet seats 1
  • Use commercially available cleaners according to label instructions 1

Treatment Options for Staph Infections

For Minor Skin Infections (Impetigo, Small Lesions)

• Topical mupirocin 2% ointment applied to affected areas after bathing when skin is clean and dry 2, 3

For More Extensive Infections

• Incision and drainage for abscesses (primary treatment) 4
• Oral antibiotics based on severity and suspected resistance:
  • Cephalexin for methicillin-susceptible S. aureus (MSSA) 5
  • For methicillin-resistant S. aureus (MRSA): clindamycin 600mg PO three times daily or trimethoprim-sulfamethoxazole 1
  • Duration: 7-14 days depending on clinical response 1

For Severe Infections Requiring Hospitalization

• Intravenous options include:
  • Vancomycin (first-line for MRSA) 1
  • Linezolid 600mg twice daily 1
  • Daptomycin 4 mg/kg/dose once daily 1
  • Clindamycin (if low resistance rates) 1

Management of Recurrent Staph Infections

When to Consider Decolonization

• When a patient develops recurrent skin infections despite optimizing wound care and hygiene measures 1
• When ongoing transmission is occurring among household members 1

Decolonization Protocol

1. Nasal decolonization with mupirocin twice daily for 5-10 days 1
2. PLUS topical body decolonization with either:
   • Chlorhexidine washes for 5-14 days, OR
   • Dilute bleach baths (1 tsp per gallon of water or ¼ cup per ¼ tub) for 15 minutes twice weekly for 3 months 1

Household Approach

• All household members should be evaluated for evidence of infection 1, 6
• Symptomatic contacts should be treated 1
• Apply personal and environmental hygiene measures for all household members 1

Common Pitfalls to Avoid

• Not covering draining wounds, which increases transmission risk 1
• Sharing personal items (towels, razors) that have contacted infected skin 2
• Using hot water for bathing, which may increase bacterial spread 2
• Treating only the infected individual rather than addressing household transmission 6, 4
• Failing to complete the full course of antibiotics, which may lead to recurrence and resistance 7

By following these prevention and treatment strategies, you can effectively manage staph infections and reduce the risk of recurrence and transmission to others.