The Skinny on Staph in the US

Written by: Jessica Lysne

Edited by: Lauren Heinzinger

This piece was written in collaboration with the 2025 ComSciCon-MI Write-A-Thon.

“I’m working in a staph lab,” I tell a friend from college when we see each other for the first time in a while.

“Ugh! Staph! I hate staph!” She says with a full-body shudder. As a fully licensed pharmacist these days, she works in the Veterans Affairs (VA) hospital on our old university campus. She adds, after the shudder, “Oh, but I’m glad you like it!”

I do like my work, but staph… Well, it’s certainly not a glamorous bug. If you haven’t had the privilege of contracting a staph infection, let me be the first to tell you: they’re irritating, painful, and often downright gross. Sometimes, they can even be deadly.

“Staph” refers to Staphylococcus aureus, or S. aureus. About one in three people carry it in their nostrils; others might have staph living elsewhere on their skin, as “transient”, or temporary, residents (1, 2).  Once, my lab mate even discovered a thriving colony inside his belly button, though by the following week the bacteria were already gone. The point is this: staph is everywhere, and usually harmless (I promise).

However, staph is not always harmless. We call it an “opportunistic pathogen,” meaning it can cause disease under certain conditions. Perhaps a weakened immune system, or a break in the skin (an open cut, insect bite, etc.) can provide staph its chance to move into deeper tissues. From there, the bug can release toxins which damage cells and even spread into other parts of the body; a staph infection could therefore result in anything from cellulitis (a nasty bump on your leg) to endocarditis (a serious infection in your heart) (3, 4, 5).

A hundred years ago, a staph infection had an 80% chance of killing you (6). Luckily, we’ve since developed a plethora of antibiotics to fight off infections. Unluckily, since bacteria can grow and divide very quickly, they rapidly acquire strategies to evade or resist these antibiotics. That’s why the last time you showed up at Urgent Care with a sinus infection, your nurse was so insistent that you take your full course of antibiotics — yes, even when you felt better. Just a few cells left over after treatment can give rise to stronger bacteria, which are better able to fight off the next course of antibiotics. In fact, penicillin-resistant S. aureus was recovered from four hospitalized patients all the way back in 1942, only a year after penicillin was first available commercially (7).

Today, antibiotic-resistant staph is a major problem. We call it MRSA: Methicillin Resistant (sometimes, Multi-drug Resistant) Staphylococcus aureus. MRSA, since first appearing in the early 1960s, has spread rapidly around the globe, and many countries now report that 50% or more of infective S. aureus hospital cases are MRSA (8). While MRSA cases were originally nosocomial (i.e., acquired in the hospital),  they have increasingly shown up in “community-associated” outbreaks, spreading through the population and causing disease in otherwise healthy individuals.

Basically, staph infections can be serious, and they can be seriously hard to treat.

Okay, you ask, so what does that have to do with me? Here in the US, staph infections aren’t necessarily top of mind when we think of major healthcare concerns. Instead, we think of chronic disease: diabetes, heart failure, and COPD. Cancer. Obesity. The aging population of our country. Any combination of the above.

Every one of these conditions is a major risk factor for MRSA.

Take diabetes, for example, which affects 12% of Americans today (9). A common complication for diabetes patients are slow-healing foot ulcers; these ulcers frequently progress to infection of the foot, which can spread to the bone. About one in six of these patients will require amputation. One in seven will succumb to the infection entirely. And what, in most cases, causes the infection? 

Staphylococcus aureus (10).

Let’s bring this back to my friend, the pharmacist: at the VA where she works, half of her patients are over 65 (11). Veterans, compared to the general US population, have higher rates of many chronic diseases, even adjusted for their age (12). Notedly, around 25% of veterans have diabetes— more than twice that of everyone else (13). Looking at these stats, I can guess why my friend might be so darn sick of dealing with staph infections.

I wonder if the VA isn’t a model for what’s to come for the rest of our country, with the number of adults aged 65 and older projected to nearly double to almost 90 million by 2050 (14). With aging come hospital stays and joint replacements (more infection risks), as well as the aforementioned chronic diseases. Today, the CDC estimates that MRSA causes more than 70,000 severe infections and 9,000 deaths per year (15). What might that number look like in 2050, when it’s predicted that the number of deaths attributed to antimicrobial resistance will equal the number of deaths to cancer today? (16)

Thousands of researchers worldwide are working to solve this coming crisis and are dedicated to understanding staph’s wily ways— what makes it so good at surviving and adapting to its host (i.e., us)? How can we use those strategies against it? 

In the meantime, wipe down your gym equipment, don’t pick at strange-looking pimples, keep some neosporin handy, and take all your antibiotics (but only when they’re prescribed!).