Staph Skin Infections In Babies: Causes, Symptoms And Treatment

Staph infection or MRSA skin infection in babies and young children is a serious health concern. As a parent, here's what you should know about the causes and symptoms of staph infection.

By Dr Shyam Kumar

Staph Skin Infections In Babies: Causes, Symptoms And Treatment

Three-year-old Gaurav developed pus-filled boils after he spent a month in a neighbourhood day care centre. It all started with a few small red spots around his mouth and nose. But, soon they spread all over his face and then to his hands. The sores soon changed into pus-filled boils. A visit to the doctor confirmed that Gaurav had impetigo, a contagious form of staphylococcal infection.

Newborns, infants and young children are more susceptible to staphylococcal skin infections. Infection with MRSA (methicillin-resistant Staphylococcus aureus), a type of antibiotic-resistant bacteria, can give rise to skin infections and diaper rash in babies.

But, with neglect or improper treatment, staphylococcus (staph) infection or MRSA infection can turn life-threatening.

So, it is important for parents to know about the causes and symptoms of staph infections in babies and how to prevent them.

What causes staph infections

Most common bacterial skin infections are caused by the staph bacteria. However, of the many strains of staph, the species usually responsible for skin infections in babies is Staphylococcus aureus.

Generally, staph infection symptoms manifest as small skin rashes and fever. However, individuals with skin diseases such as eczema are more vulnerable to this infection.

The staph bacteria is usually found either on the skin or nostrils of healthy individuals. In fact, studies indicate S. aureus is present in the nose of one in every three healthy individuals.

But, when staph enters the body through cuts or bruises and reaches the organs, bones, joints or blood vessels, the situation can turn serious. If the bacteria find their way into the blood stream, the patient can suffer septicaemia or septic shock.

The staph bacteria can cause:

  1. Skin infections such as cellulitis, impetigo, scalded skin syndrome and MRSA
  2. Wound infections
  3. Surgical site infections (in a hospital setting)
  4. Food poisoning caused by eating foods contaminated with toxins produced by S. aureus
  5. Urinary tract infections
  6. Pneumonia (lung infection)
  7. Toxic shock syndrome (a life-threatening condition caused by bacterial toxins)
"Boils and rashes can be caused due to several reasons like bacterial or viral infections, heat, allergies, insect bites and immune disorders. The cause determines the care. Rashes can also be caused due to food allergy, use of new skin or hair products, or exposure to certain chemicals.
You can try to use prickly heat powder in case of rash due to heat, and calamine lotion to soothe the skin in case of rash due to allergies or infections. However, in the case of children, it is best to consult your skincare specialist and / or paediatrician to avoid complications."
— Dr Rinky Kapoor, Cosmetic Dermatologist & Dermato-Surgeon, The Esthetic Clinics

Common staphylococcal skin infections

Some of the most common staph-related skin infections in children are impetigo or school sores, folliculitis and boils, and MRSA infection.

  1. Folliculitis: Staph can cause infection of the hair follicles (hair root). The first sign of folliculitis is the appearance of tiny red or white-headed pimples on the skin near the base of the hair. This is associated with itchy, tender and inflamed skin.
  2. Furuncle (boil): If your child has an open wound, eczema, diabetes or anaemia, he is at risk of developing boils. A boil appears when staph infects the deeper tissues. The boil appears as a pink or red abscess filled with pus. It is painful and warm to the touch. It would eventually rupture and crust over. Boils caused by staph infection commonly occur on the scalp, face, neck, armpits or buttocks.
  3. Cellulitis: This is a serious infection. It occurs when the staph bacteria enter the skin from an open wound, boil, insect bite or burn. The affected area turns red, swollen, warm and tender. The redness keeps spreading, and pus or fluid oozes from the skin. A child with cellulitis can develop low-grade fever and swollen lymph nodes. Cellulitis usually occurs in the lower limbs, but other areas of the body can also be affected.
  4. Impetigo (school sores): If a child has sores clustered around the nose or mouth, that seem to spread, she may have impetigo. This is a staph skin infection which mostly affects toddlers and young children. It is contagious and spreads easily through skin contact, sharing of clothes, and handling of infected toys or utensils. Diaper rash is a term for impetigo or staph infection in babies localised to the area covered by the diaper. Rashes caused primarily by contact dermatitis or skin irritation may develop into staph infection.
  5. Stye (hordeolum): S. aureus can also infect the sweat or oil-producing glands present in the eyelids. The blocked gland forms a lump over the lower or upper eyelid. Stye is very common in both children and adults. A child with stye may experience eye irritation, especially with blinking. Pus discharge, redness, swelling and discomfort in the eyelid margin may also be present.
  6. Scalded skin syndrome (SSS): A child with SSS may develop fever, rashes and, sometimes, blisters. Mostly seen in newborns and children below five years of age, SSS is a serious staph infection. In SSS, the skin starts to peel because of a toxin produced by the bacteria. Since the affected area looks like a burn injury, the infection is called 'scalded skin syndrome'.

What is MRSA infection?

Some strains of the S. aureus have become resistant to common antibiotics such as penicillin and amoxicillin. These drug-resistant bacteria are called MRSA. In the past MRSA was considered a hospital-acquired infection. However, it can spread through contact. So, children can get easily infected from a cut, abrasion or an open wound. MRSA can quickly spread within the body if left untreated.

"White patches around the mouth and neck can be due to a skin disease called vitiligo, or due to a dry skin condition called pityriasis alba, fungal infections like candida or pityriasisversicolor, or even sun allergy.
The condition and the cause should always be evaluated by a dermatologist first, before starting the appropriate treatment."
— Dr Rinky Kapoor, Cosmetic Dermatologist & Dermato-Surgeon, The Esthetic Clinics

Why is staph infection in babies a concern?

MRSA in toddlers or staph skin infection in infants is usually acquired during a hospital stay. In hospitals, the transmission occurs when children come into contact with hospital staff or other patients carrying the bacteria. Babies with surgical wounds are also at risk. Staph infection in pre-term or low-weight babies can be life threatening and cause complications that require prolonged hospital admission.

How do staph infections spread?

Staph infection usually spreads by skin-to-skin contact. So, your child would not get the infection if his school friend has it. But, if your child has an open wound and he has skin-to-skin contact with an infected child, he can acquire the infection.

The staph bacteria are very resilient and can survive on objects such as clothing, furniture, sports equipment and towels. So, children in day care centres, schools, playgrounds, locker rooms, gyms, classrooms and other crowded places have a higher likelihood of getting staph infection. Poor hand hygiene also contributes to the spread of the bacteria.

Symptoms of staph infection

Keep an eye on cuts and bruises on your child's body. If you notice that your child’s injuries are slow to heal, and there is pain, redness and swelling around the area, it could be a staph infection. The wound could also ooze out pus or fluid.

Wound infected by staph develop yellow-coloured crusting or scabs. If your child has eczema, staphylococcal infection can develop in the affected areas of the skin.

Once the staph infection sets in, your child may get mild fever. He may also feel uncomfortable.

Diagnosis of staph infection

Physical exam: Your child’s doctor will closely inspect the infected area to confirm staph infection. Temperature will be measured to find out if your baby has fever.

Lab testing: A sample is collected from the infected area with a cotton swab and sent to the lab for culture and analysis. Based on the sample results, the correct antibiotic is identified to treat the infection.

"Scars due to chicken pox could be superficial where there can be only pigmented marks, or there can be pitted scars which could be superficial or deep. Rarely do these scars become thick and itchy forming keloids.
Superficial pigmented scars can be treated with skin lightening and scar reduction medicines. Deeper scars may need laser treatment. But, these procedures can be performed on children only after they are 14 years or older, and not before that."
— Dr Rinky Kapoor, Cosmetic Dermatologist & Dermato-Surgeon, The Esthetic Clinics

How to treat staph infections

If you find that your child’s wound or skin lesion isn't healing or getting worse, seek medical care right away. Simple cases of staph infection can be treated with a dose of antibiotics. But, in severe cases like SSS, your baby may develop painful bumps or blisters with itching, redness and discharge. This will need treatment with IV antibiotics and hospitalisation.

Doctors prefer topical antibiotics for treatment of impetigo. In cases with only a small area of infection, these work better than oral antibiotics. However, for severe cases, oral antibiotics are considered. With treatment, impetigo may heal in about a week to 10 days.

In the case of MRSA infection, the pus is yellow or golden in colour. Hence, this infection is also known as 'golden staph'. To treat golden staph, doctors may prescribe specific antibiotics.

Milder forms of staph infection do not require hospitalisation and can be treated at home. Wash the affected skin with an anti-bacterial cleanser. Cover the wound with a dressing if it oozes pus. In the case of boils, do not try to drain the infection as it could spread to other areas of the body. Make sure that your child finishes the antibiotics course prescribed by the doctor.

How to prevent staph infection

Staph enters the body through cuts in the skin. Infected individuals with an open or draining wound can deposit the germs on items like clothing, furniture or utensils. Even healthy individuals who are carriers can spread the germs. So, adopt the following measures to prevent the staph from spreading and infecting your child:

  1. Good hand hygiene plays a vital role in preventing staph infection. Advise your child to wash her hands thoroughly with hand sanitiser or soap under running water, and wipe the hands dry with a clean towel. If you are caring for anyone with a staph infection, make sure that you wash your hands before and after handling the wound or bandage.
  2. If someone in your home has staph infection, avoid sharing any personal items, clothes or towels with the patient to prevent the spread of bacteria to others. Teach your child to do the same.
  3. Hygiene is particularly important in day care centres and schools where children tend to share toys and sports equipment. So, ask your child to shower immediately after participating in contact sports and wash her clothes in hot water. When using shared sports equipment,  place a towel as a barrier between the equipment surface and the skin.
  4. Since staph bacteria enter the body through cuts, protect your child from injury, bug bites and sunburn. If your child’s skin tends to break out easily, ensure that you keep the wound clean and covered with bandage until it is healed.

Most cases of skin infection in children usually heal on their own or improve with application of topical ointment and proper care. However, skin infection with staph can be serious and will require antibiotics and medical intervention. If you identify any signs of staph infection in your child, seek medical attention immediately.

About the expert:

Reviewed by Dr Sravya Tipirneni on 9 August 2019

Dr Sravya Tipirneni is a highly qualified Consultant Dermatologist & Cosmetologist in a leading hospital in Bangalore, India. 

About the author:

Written by Dr Shyam Kumar on 3 August 2018; updated on 9 August 2019

The author holds a degree in Homoeopathy with an MBA in Hospital Management and has worked across multiple disciplines including healthcare and technology. As a nature lover, he attended the world's first underwater CEO's conference to combat marine pollution.

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