Impetigo
Etiologia i przyczyny

Liszajec zakaźny (impetigo) to powierzchowna, wysoce zakaźna infekcja bakteryjna skóry, najczęściej dotykająca dzieci w wieku 2-5 lat. Etiologia obejmuje głównie Staphylococcus aureus (około 80% przypadków niepryszczykowego liszajca) oraz Streptococcus pyogenes (około 10%), z infekcjami mieszanymi w 10%. Liszajec pęcherzowy wywołuje niemal wyłącznie S. aureus, szczególnie szczepy koagulazo-dodatnie, produkujące toksyny złuszczające (eksfoliatyny A i B). Drogi zakażenia to przede wszystkim przerwanie ciągłości skóry (rany, otarcia, ukąszenia owadów) oraz współistniejące dermatozy (AZS, świerzb, ospa wietrzna). Czynniki predysponujące to m.in. wiek, ciepły i wilgotny klimat, zaburzenia immunologiczne, bliski kontakt w skupiskach ludzkich, niedożywienie i nieodpowiednia higiena. Nosicielstwo S. aureus i S. pyogenes, zwłaszcza w jamie nosowej, zwiększa ryzyko zakażenia i transmisji.

Etiologia liszajca zakaźnego

Liszajec zakaźny (impetigo) jest powierzchowną, wysoce zakaźną bakteryjną infekcją skóry, która najczęściej dotyka dzieci, zwłaszcza w wieku 2-5 lat. Głównymi patogenami odpowiedzialnymi za rozwój liszajca zakaźnego są bakterie: Staphylococcus aureus oraz Streptococcus pyogenes (paciorkowiec grupy A).12

Dominujące patogeny w liszajcu zakaźnym

W przypadku liszajca zakaźnego niepryszczykowego (non-bullous impetigo), który stanowi ponad 70% wszystkich przypadków, czynniki etiologiczne rozkładają się następująco:12

  • Staphylococcus aureus – odpowiedzialny za około 80% przypadków
  • Streptococcus pyogenes (paciorkowiec grupy A) – odpowiedzialny za około 10% przypadków
  • Infekcja mieszana (oba patogeny jednocześnie) – w około 10% przypadków

Liszajec zakaźny pęcherzowy (bullous impetigo) jest wywoływany niemal wyłącznie przez Staphylococcus aureus, szczególnie przez koagulazo-dodatni szczep S. aureus grupy II, najczęściej typ fagowy 71. Szczepy gronkowcowe wywołujące liszajec pęcherzowy wytwarzają toksyny złuszczające (eksfoliatyny A i B).123

Wrota zakażenia

Bakterie wywołujące liszajec zakaźny wnikają do organizmu najczęściej w następujący sposób:123

  • Przerwanie ciągłości skóry – bakterie wnikają przez uszkodzoną skórę w wyniku:
    • Drobnych ran i otarć
    • Ukąszeń owadów
    • Zadrapań
    • Niewielkich urazów mechanicznych
  • Współistniejące dermatozy – rozwój zakażenia na podłożu istniejących wcześniej chorób skóry:
    • Atopowe zapalenie skóry (wyprysk)
    • Świerzb
    • Wszawica
    • Kontaktowe zapalenie skóry
    • Ospa wietrzna

Warto podkreślić, że liszajec zakaźny może również rozwinąć się na pozornie nieuszkodzonej skórze, co określa się mianem pierwotnego liszajca zakaźnego (primary impetigo). Zakażenie występujące na skórze uszkodzonej przez inną chorobę nazywane jest wtórnym liszajcem zakaźnym (secondary impetigo).123

Czynniki ryzyka rozwoju liszajca zakaźnego

Istnieje szereg czynników predysponujących do rozwoju liszajca zakaźnego:123

  • Wiek – dzieci w wieku 2-5 lat są najbardziej narażone; u dzieci poniżej 2 roku życia dominuje postać pęcherzowa (bullous impetigo)
  • Warunki klimatyczne – ciepła i wilgotna pogoda sprzyja namnażaniu się bakterii, co powoduje szczyt zachorowań w okresie letnim i jesiennym
  • Zaburzenia immunologiczne – osoby z obniżoną odpornością (np. w przebiegu cukrzycy, zakażenia HIV, podczas chemioterapii)
  • Stłoczenie i bliski kontakt – przebywanie w zatłoczonych miejscach, takich jak:
    • Żłobki i przedszkola
    • Szkoły
    • Obiekty wojskowe i więzienia
  • Uprawianie sportów kontaktowych – takich jak zapasy czy futbol amerykański
  • Niedożywienie
  • Nieodpowiednia higiena

Dodatkowe czynniki zwiększające ryzyko liszajca zakaźnego to: otyłość, stosowanie kortykosteroidów, chemioterapia, dysplazje układu immunologicznego oraz przewlekłe choroby ziarniniakowe.12

Nosicielstwo bakterii a rozwój liszajca zakaźnego

Istotnym czynnikiem w epidemiologii liszajca zakaźnego jest nosicielstwo bakterii. Wiele osób może być kolonizowanych przez Staphylococcus aureus i Streptococcus pyogenes bez objawów klinicznych infekcji:123

  • Bakterie mogą bytować na skórze i błonach śluzowych (zwłaszcza w jamie nosowej) bezobjawowo
  • Część populacji jest trwale skolonizowana przez patogenne szczepy bakterii
  • Nosicielstwo w jamie nosowej często prowadzi do nawracających zakażeń liszajcem zakaźnym
  • Osoby skolonizowane przez bakterie mają większe ryzyko rozwoju liszajca zakaźnego i mogą stanowić źródło zakażenia dla innych

Szczepy oporne na antybiotyki

W ostatnich latach coraz większym problemem stają się szczepy bakterii oporne na antybiotyki:1234

  • MRSA (metycylinooporne szczepy Staphylococcus aureus) – izolowane nawet w 20% przypadków liszajca pęcherzowego
  • Odnotowuje się rosnącą częstość występowania pozaszpitalnych zakażeń MRSA (community-acquired MRSA)
  • Szczepy oporne na gentamycynę – również raportowano ich udział w etiologii liszajca zakaźnego
  • W przypadku podejrzenia zakażenia MRSA, zaleca się stosowanie trimetoprimu z sulfametoksazolem, klindamycyny lub tetracyklin (doksycyklina, minocyklina) do czasu otrzymania wyników posiewu

Drogi zarażenia i okres wylęgania

Liszajec zakaźny charakteryzuje się wysoką zakaźnością, a przenoszenie infekcji może odbywać się na kilka sposobów:123

  • Bezpośredni kontakt z wykwitami skórnymi osoby zakażonej
  • Kontakt pośredni poprzez dotykanie przedmiotów skażonych wydzieliną ze zmian skórnych:
    • Ubrania i pościel
    • Ręczniki
    • Zabawki
    • Przybory toaletowe
  • Nosicielstwo w jamie nosowej i przenoszenie bakterii na skórę

Okres wylęgania (inkubacji) liszajca zakaźnego zależy od rodzaju bakterii wywołującej zakażenie:12

  • 1-3 dni po ekspozycji na Streptococcus pyogenes
  • 4-10 dni po ekspozycji na Staphylococcus aureus

Liszajec zakaźny przestaje być zaraźliwy po 48 godzinach od rozpoczęcia skutecznego leczenia antybiotykami lub gdy zmiany skórne przestają być sączące i pokrywają się strupami.1

Potencjalne powikłania liszajca zakaźnego

Liszajec zakaźny wywołany przez paciorkowce grupy A może prowadzić do powikłań, z których najważniejsze to:12

  • Popaciorkowcowe kłębuszkowe zapalenie nerek (PSGN) – występuje u do 5% pacjentów z liszajcem zakaźnym niepryszczykowym
  • Gorączka reumatyczna – nowsze badania sugerują, że może wystąpić jako powikłanie liszajca zakaźnego, choć tradycyjnie wiązana była głównie z infekcją gardła
  • Ropnie skórne – przy nieleczonych lub źle leczonych infekcjach

W przypadku noworodków liszajec zakaźny może być poważnym schorzeniem ze względu na niedojrzały układ odpornościowy, który może nie być w stanie skutecznie ograniczyć infekcji.1

Specyfika szczepów paciorkowcowych

Wieloletnie badania epidemiologiczne wskazują na istnienie wyraźnego zróżnicowania szczepów paciorkowcowych pod względem tropizmu tkankowego:1

  • Niektóre szczepy paciorkowców grupy A wywołują głównie zakażenia gardła i migdałków, rzadko powodując liszajec zakaźny
  • Istnieje odrębna grupa szczepów, które predysponują do zakażeń skórnych, ale nie atakują gardła
  • Szczepy paciorkowcowe wywołujące liszajec zakaźny to najczęściej typy 49, 52, 53, 55-57, 59 i 61

Podsumowując, etiologia liszajca zakaźnego jest złożona i obejmuje interakcję między patogenami bakteryjnymi a czynnikami ryzyka ze strony gospodarza i środowiska. Dominująca rola Staphylococcus aureus i Streptococcus pyogenes w patogenezie tej choroby, wraz z rosnącym znaczeniem szczepów opornych na antybiotyki, stanowi istotne wyzwanie diagnostyczne i terapeutyczne w praktyce klinicznej.123

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  1. 12.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Impetigo, Contagious Skin Infection: Causes, Treatment & Prevention
    https://my.clevelandclinic.org/health/diseases/15134-impetigo
    Impetigo is a common skin infection that most often affects young children. Bacteria including Staphylococcus aureus (S. aureus or staph) and Group A streptococcus (strep) cause the infection, which can lead to itchy sores and blisters. […] Impetigo causes include certain types of bacteria that lead to infection. The most common impetigo bacteria include: Staphylococcus aureus (S. aureus or staph): S. aureus causes 80% of non-bullous impetigo cases. […] Group A streptococcus (strep): Group A strep causes 10% of non-bullous cases. […] The bacteria usually enter your child’s skin through a cut, scrape, rash or insect bite. After they enter your child’s body, the bacteria continue growing in their skin. This can lead to inflammation and infection in the top layers of your child’s skin. […] Impetigo may also occur without any skin breakage. Instead, it can occur after you’ve experienced another skin condition, such as: Head lice. Scabies. Eczema. […] Adults can also get impetigo through health conditions such as tattoo infections.
  • #1 Impetigo – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK430974/
    Impetigo is a common infection of the superficial layers of the epidermis that is highly contagious and most commonly caused by gram-positive bacteria. […] Nonbullous impetigo is most commonly caused by S aureus which is responsible for 80% of cases. Group A beta-hemolytic Strep (GABHS) accounts for 10% of cases and the causative agent is a combination of S. aureus and GABHS 10% of the time. […] Bullous impetigo is caused almost exclusively by S aureus. […] Impetigo accounts for approximately 10% of skin complaints in the pediatric population. […] The peak incidence is during summer and fall. […] Children younger than two account for 90% of cases of bullous impetigo. […] Methicillin-resistant S aureus (MRSA) has become more prevalent, especially in hospitalized patients. […] Today, community-acquired MRSA is rapidly increasing. […] The condition is more common in populations living in close quarters, daycare centers and prisons.
  • #1 Impetigo | NHS inform
    https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/impetigo/
    Impetigo occurs when the skin becomes infected with bacteria, usually either Staphylococcus aureus or Streptococcus pyogenes. […] The bacteria can infect the skin in 2 main ways: through a break in otherwise healthy skin such as a cut, insect bite or other injury this is known as primary impetigo […] through skin damaged by another underlying skin condition, such as head lice, scabies or eczema this is known as secondary impetigo. […] The bacteria can be spread easily through close contact with someone who has the infection, such as through direct physical contact, or by sharing towels or flannels. […] As the condition doesn’t cause any symptoms until 4 to 10 days after initial exposure to the bacteria, it’s often easily spread to others unintentionally. […] Children and people with diabetes or a weakened immune system either due to a condition such as HIV or a treatment such as chemotherapy are most at risk of developing impetigo.
  • #1 Impetigo: Diagnosis and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0815/p229.html
    Impetigo is the most common bacterial skin infection in children two to five years of age. […] Nonbullous impetigo, or impetigo contagiosa, is caused by Staphylococcus aureus or Streptococcus pyogenes, and is characterized by honey-colored crusts on the face and extremities. […] Impetigo is a common bacterial skin infection caused by Staphylococcus aureus, group A beta-hemolytic Streptococcus pyogenes, a combination of the two, or less commonly, anaerobic bacteria. […] Other factors that predispose to impetigo are skin trauma; hot, humid climates; poor hygiene; day care settings; crowding; malnutrition; and diabetes mellitus or other medical comorbidities. […] The highly contagious nature of impetigo also allows spread from patients to close contacts. […] The number of possible causes, incidence, and clinical severity of acute poststreptococcal glomerulonephritis have decreased, because the causative organism of impetigo has shifted from S. pyogenes to S. aureus.
  • #1
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4008061/
    Impetigo is a common cutaneous infection that is especially prevalent in children. Historically, impetigo is caused by either group A -hemolytic streptococci or Staphylococcus aureus. Currently, the most frequently isolated pathogen is S. aureus. […] The presence of maceration, humidity, previous skin lesions, obesity, corticosteroid or chemotherapy treatments, dysglobulinemias, leukocyte disorders such as leukemia and chronic granulomatous disease, diabetes, malnutrition, other congenital or acquired immunodeficiencies, such as AIDS, are predisposing factors. […] Several decades of epidemiological studies indicate that there are some strains of group A streptococci that elicit oropharyngeal infections, but rarely cause impetigo. On the other hand, there is a distinct group of strains that cause cutaneous infection but that do not affect the throat.
  • #1 Impetigo | Cedars-Sinai
    https://www.cedars-sinai.org/health-library/diseases-and-conditions/i/impetigo.html
    Impetigo is an infection of the outer layer of the skin. Its most often caused by the bacteria Staphylococcus aureus (called staph) or Streptococcus pyogenes (called group A strep). […] Impetigo is caused by bacteria. The most common is Staphylococcus aureus, also called staph. Streptococci bacteria can also cause impetigo. […] Some impetigo is caused by a type of bacteria called MRSA (methicillin-resistant Staphylococcus aureus). This type of bacteria is hard to kill. This type of impetigo can be hard to treat. […] Many people have these kinds of bacteria on their body from time to time. A smaller number of people have lifelong (permanent) colonies of these harmful bacteria on their skin. This is known as being colonized with the bacteria. […] People who have these bacteria on their skin are more likely to get impetigo. You may also get impetigo if you have a cut that has been in contact with someone colonized with the bacteria.
  • #1 Impetigo – Wikipedia
    https://en.wikipedia.org/wiki/Impetigo
    Impetigo is primarily caused by Staphylococcus aureus, and sometimes by Streptococcus pyogenes. […] Both bullous and nonbullous are primarily caused by S. aureus, with Streptococcus also commonly being involved in the nonbullous form. […] Impetigo is more likely to infect children ages 2 to 5, especially those that attend school or day care. […] The infection is spread by direct contact with lesions or with nasal carriers. […] The incubation period is 1 to 3 days after exposure to Streptococcus and 4 to 10 days for Staphylococcus.
  • #1 Impetigo | NHS inform
    https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/impetigo/
    Impetigo stops being infectious after 48 hours of treatment starting or after the sores have stopped blistering or crusting. […] In addition to the situations mentioned above, there are a number of other factors that can increase your chances of developing impetigo. […] Impetigo isn’t usually serious and often clears up without treatment after 2 to 3 weeks. […] Treatment is often recommended as it can help clear up the infection in around 7 to 10 days and reduce the risk of the infection being passed on to others. […] If impetigo is confirmed, it can usually be effectively treated with antibiotics. […] If the infection is being caused by an underlying skin condition, such as eczema, this may also need to be treated.
  • #1 Clinical Guidance for Group A Streptococcal Impetigo | Group A Strep | CDC
    https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/impetigo.html
    PSGN is thought to be the result of an immune response that is triggered by the group A strep infection. […] However, new evidence suggests that acute rheumatic fever can occur as a complication after group A strep skin infections, including impetigo. […] Antibiotic treatment limits someone’s ability to transmit group A strep bacteria. […] Good hand hygiene and respiratory etiquette can reduce the spread of group A strep bacteria.
  • #1 Impetigo – school sores | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/impetigo-school-sores
    Impetigo (school sores) is a highly contagious type of skin infection caused by Staphylococcus or Streptococcus bacteria. […] Impetigo is a skin infection caused by staphylococcus or streptococcus bacteria. […] Staphylococcus or streptococcus bacteria can live harmlessly on and inside various areas of the body, such as the skin surface and nose. However, cuts and abrasions or eczema may allow the bacteria to cause infection in deeper skin tissues. […] Impetigo can be treated with prescription antibiotic ointments or creams, which need to be reapplied until the sores have completely healed. Antibiotic syrups or tablets may also be prescribed. […] If left untreated, impetigo can lead to skin abscesses. […] Impetigo is a serious condition for newborns because the newborn’s inexperienced immune system may not keep the infection in check.
  • #2 Impetigo – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK430974/
    Impetigo is a common infection of the superficial layers of the epidermis that is highly contagious and most commonly caused by gram-positive bacteria. […] Nonbullous impetigo is most commonly caused by S aureus which is responsible for 80% of cases. Group A beta-hemolytic Strep (GABHS) accounts for 10% of cases and the causative agent is a combination of S. aureus and GABHS 10% of the time. […] Bullous impetigo is caused almost exclusively by S aureus. […] Impetigo accounts for approximately 10% of skin complaints in the pediatric population. […] The peak incidence is during summer and fall. […] Children younger than two account for 90% of cases of bullous impetigo. […] Methicillin-resistant S aureus (MRSA) has become more prevalent, especially in hospitalized patients. […] Today, community-acquired MRSA is rapidly increasing. […] The condition is more common in populations living in close quarters, daycare centers and prisons.
  • #2
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4008061/
    The presence of MRSA as impetigo’s causative agent in non-hospitalized patients is considered unusual and with heterogeneous distribution. Staphylococcal impetigo is usually caused by S. aureus strains that possess the exfoliative toxin gene. […] Non-bullous impetigo represents more than 70% of all cases of impetigo. It occurs in adults and children but rarely in those under two years of age. The main etiological agent has varied over time. S. aureus was the predominant agent in the 40s and 50s, with a later increase in the prevalence of streptococcus. In studies conducted over the past three decades, there has been a resurgence of S. aureus as the main agent of crusted impetigo. […] Crusted impetigo can occur in normal skin or impetiginisation may appear over a previous dermatosis such as atopic dermatitis, contact dermatitis, insect bites, pediculosis and scabies. Malnutrition and poor hygiene are predisposing factors.
  • #2 Impetigo (school sores, skin infections): Images, Causes, and Symptoms — DermNet
    https://dermnetnz.org/topics/impetigo
    Impetigo is typically caused by Staphylococcus aureus and Streptococcus pyogenes (Group A beta haemolytic streptococci (GABHS)). […] Impetigo is caused by Staphylococcus aureus, and less commonly Streptococcus pyogenes. […] Non-bullous impetigo is caused by either Staphylococcus aureus, Streptococcus pyogenes, or both bacteria conjointly. […] Bullous impetigo is due to Staphylococcus aureus which produces exfoliative toxins (exfoliatins A and B).
  • #2 Impetigo, Contagious Skin Infection: Causes, Treatment & Prevention
    https://my.clevelandclinic.org/health/diseases/15134-impetigo
    Impetigo is a common skin infection that most often affects young children. Bacteria including Staphylococcus aureus (S. aureus or staph) and Group A streptococcus (strep) cause the infection, which can lead to itchy sores and blisters. […] Impetigo causes include certain types of bacteria that lead to infection. The most common impetigo bacteria include: Staphylococcus aureus (S. aureus or staph): S. aureus causes 80% of non-bullous impetigo cases. […] Group A streptococcus (strep): Group A strep causes 10% of non-bullous cases. […] The bacteria usually enter your child’s skin through a cut, scrape, rash or insect bite. After they enter your child’s body, the bacteria continue growing in their skin. This can lead to inflammation and infection in the top layers of your child’s skin. […] Impetigo may also occur without any skin breakage. Instead, it can occur after you’ve experienced another skin condition, such as: Head lice. Scabies. Eczema. […] Adults can also get impetigo through health conditions such as tattoo infections.
  • #2 Impetigo: MedlinePlus Medical EncyclopediaLock
    https://medlineplus.gov/ency/article/000860.htm
    Impetigo is caused by streptococcus (strep) or staphylococcus (staph) bacteria. Methicillin-resistant staph aureus (MRSA) is an increasing cause. […] When there is a break in the skin, bacteria can enter the body and grow there. This causes inflammation and infection. Breaks in the skin may occur from injury or trauma to the skin or from insect, animal, or human bites. […] Impetigo may also occur on the skin, where there is no visible break. […] In adults, it may occur following another skin problem. It may also develop after a cold or other virus.
  • #2 What Is Impetigo? Symptoms, Causes, Diagnosis, Treatment, and Prevention
    https://www.everydayhealth.com/impetigo/guide/
    Impetigo is caused by either the Staphylococcus aureus bacteria, which can cause a staph infection, or by the strep throat-causing bacteria group A streptococcus. […] Bacteria can enter the skin through an injury and infect the top layer of skin. […] Any type of skin injury puts you at risk for impetigo. This includes minor injuries, such as a scrape or a cut. Having an insect bite also increases the risk of impetigo. […] Sometimes, impetigo develops when the skin hasn’t been injured. Because this is a highly contagious skin infection, coming in close contact with someone who has an active infection raises your risk. […] It’s easily passed through skin-to-skin contact, or by sharing toys, bed linens, and towels. For this reason, crowded areas, such as a child care center, can hasten the spread of impetigo.
  • #2 Impetigo: Diagnosis and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0815/p229.html
    Impetigo is the most common bacterial skin infection in children two to five years of age. […] Nonbullous impetigo, or impetigo contagiosa, is caused by Staphylococcus aureus or Streptococcus pyogenes, and is characterized by honey-colored crusts on the face and extremities. […] Impetigo is a common bacterial skin infection caused by Staphylococcus aureus, group A beta-hemolytic Streptococcus pyogenes, a combination of the two, or less commonly, anaerobic bacteria. […] Other factors that predispose to impetigo are skin trauma; hot, humid climates; poor hygiene; day care settings; crowding; malnutrition; and diabetes mellitus or other medical comorbidities. […] The highly contagious nature of impetigo also allows spread from patients to close contacts. […] The number of possible causes, incidence, and clinical severity of acute poststreptococcal glomerulonephritis have decreased, because the causative organism of impetigo has shifted from S. pyogenes to S. aureus.
  • #2 Impetigo: Causes, Symptoms, and Treatment
    https://patient.info/childrens-health/impetigo-leaflet
    Impetigo is a skin infection. It is usually caused by a germ (bacterium). Often, one of the following three types of bacterial infection is responsible for impetigo: […] Staphylococcus aureus (the most common cause). […] Streptococcus pyogenes (also known as group A streptococcus). […] Meticillin-resistant Staphylococcus aureus (MRSA). This is a newer type of bacterium which has become resistant to many antibiotics. […] In primary impetigo, the infection affects healthy skin. […] In secondary impetigo, the infection affects skin that is already 'broken’ by other skin conditions. […] Impetigo commonly occurs in children but it can affect anyone at any age. […] You are more prone to develop impetigo if you have diabetes or if you have a weakened immune system (for example, if you are having chemotherapy). […] A possible cause for this is if the germ (bacterium) causing the infection is resistant to the prescribed cream or tablet. […] A possible cause for this is that the bacteria that cause the infection can sometimes live in (’colonise’) the nose.
  • #2 Impetigo | Cedars-Sinai
    https://www.cedars-sinai.org/health-library/diseases-and-conditions/i/impetigo.html
    Impetigo is an infection of the outer layer of the skin. Its most often caused by the bacteria Staphylococcus aureus (called staph) or Streptococcus pyogenes (called group A strep). […] Impetigo is caused by bacteria. The most common is Staphylococcus aureus, also called staph. Streptococci bacteria can also cause impetigo. […] Some impetigo is caused by a type of bacteria called MRSA (methicillin-resistant Staphylococcus aureus). This type of bacteria is hard to kill. This type of impetigo can be hard to treat. […] Many people have these kinds of bacteria on their body from time to time. A smaller number of people have lifelong (permanent) colonies of these harmful bacteria on their skin. This is known as being colonized with the bacteria. […] People who have these bacteria on their skin are more likely to get impetigo. You may also get impetigo if you have a cut that has been in contact with someone colonized with the bacteria.
  • #2 Impetigo: Symptoms, Causes, Pictures, and Treatment
    https://www.healthline.com/health/impetigo
    Impetigo is a common contagious skin infection. Bacteria like Staphylococcus aureus or Streptococcus pyogenes infect the outer layer of your skin called the epidermis. […] Strains of Staphylococcus (staph) or Streptococcus (strep) bacteria cause impetigo. […] These bacteria can get into your body through a break in your skin from a cut, scratch, insect bite, or rash. […] The disease can be contagious. You can contract these bacteria if you touch the sores of a person with impetigo or if you touch items like towels, clothes, or sheets that the person used. […] Inadequate hygiene does not cause impetigo, but it can increase the risk of contracting the bacteria, which can enter a wound or scratch through the broken skin.
  • #2 Impetigo Contagious Symptoms, Causes & Infection Treatment
    https://www.medicinenet.com/impetigo/article.htm
    Impetigo is contagious and is caused by strains of both staph and strep bacteria. […] Impetigo (pronounced im-puh-TIE-go) is a contagious, superficial infection of the skin caused by Staphylococcus (staph) and Streptococcus (strep) bacteria. […] Impetigo is most likely to occur in warm and humid environments and is most commonly spread by close contact (such as between family members). […] Bacteria that cause impetigo may enter through a break in the skin, such as that which comes from cuts and scrapes. […] Heat, humidity, and the presence of eczema predispose a person to develop impetigo. […] Recurrent impetigo infections may be associated with staph or strep bacteria residing in the nose and spreading to other parts of the skin. […] The incubation period (the time between exposure to the bacteria and the first development of symptoms) depends on the infective bacteria. Strep-caused impetigo has a shorter incubation period (one to three days) than staph-caused impetigo (four to 10 days).
  • #2 Impetigo: Diagnosis and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0815/p229.html
    There are no data to indicate that antibiotic treatment of impetigo has any effect on preventing the development of acute poststreptococcal glomerulonephritis, which can occur in up to 5% of patients with nonbullous impetigo. […] The incidence of MRSA-related skin and soft tissue infections was increasing, but more recent studies show it may be declining. […] If MRSA infection is suspected, initial treatment with trimethoprim/sulfamethoxazole, clindamycin, or a tetracycline (doxycycline or minocycline [Minocin]) is recommended pending culture results.
  • #2 Impetigo: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/965254-overview
    Impetigo is primarily caused by Streptococcus pyogenes or Staphylococcus aureus. […] Methicillin-resistant S aureus (MRSA) and gentamicin-resistant S aureus strains have also been reported to cause impetigo. […] Impetigo is caused by bacterial infection. Both S aureus and GABHS cause nonbullous impetigo; S aureus accounts for approximately 80% of cases, GABHS accounts for 10% of cases, and both organisms are recovered in 10% of cases. Bullous impetigo is caused almost exclusively by S aureus. […] Nonbullous impetigo can be caused by GABHS (types 49, 52, 53, 55-57, 59, 61) or by S aureus; in approximately 20-45% of cases, both agents are present. […] While in the past, GABHS and S aureus were equally frequent causative agents for nonbullous impetigo, currently S aureus accounts for 50-60% of cases. […] Coagulase-positive group II S aureus, most often phage type 71, is the predominant causative organism of bullous impetigo. […] MRSA has been isolated in as many as 20% of bullous impetigo cases. […] Community-acquired MRSA is a growing problem.
  • #3 Impetigo: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/965254-overview
    Impetigo is primarily caused by Streptococcus pyogenes or Staphylococcus aureus. […] Methicillin-resistant S aureus (MRSA) and gentamicin-resistant S aureus strains have also been reported to cause impetigo. […] Impetigo is caused by bacterial infection. Both S aureus and GABHS cause nonbullous impetigo; S aureus accounts for approximately 80% of cases, GABHS accounts for 10% of cases, and both organisms are recovered in 10% of cases. Bullous impetigo is caused almost exclusively by S aureus. […] Nonbullous impetigo can be caused by GABHS (types 49, 52, 53, 55-57, 59, 61) or by S aureus; in approximately 20-45% of cases, both agents are present. […] While in the past, GABHS and S aureus were equally frequent causative agents for nonbullous impetigo, currently S aureus accounts for 50-60% of cases. […] Coagulase-positive group II S aureus, most often phage type 71, is the predominant causative organism of bullous impetigo. […] MRSA has been isolated in as many as 20% of bullous impetigo cases. […] Community-acquired MRSA is a growing problem.
  • #3 Impetigo: Symptoms, Causes, Pictures, and Treatment
    https://www.healthline.com/health/impetigo
    Impetigo is a common contagious skin infection. Bacteria like Staphylococcus aureus or Streptococcus pyogenes infect the outer layer of your skin called the epidermis. […] Strains of Staphylococcus (staph) or Streptococcus (strep) bacteria cause impetigo. […] These bacteria can get into your body through a break in your skin from a cut, scratch, insect bite, or rash. […] The disease can be contagious. You can contract these bacteria if you touch the sores of a person with impetigo or if you touch items like towels, clothes, or sheets that the person used. […] Inadequate hygiene does not cause impetigo, but it can increase the risk of contracting the bacteria, which can enter a wound or scratch through the broken skin.
  • #3 Impetigo: Causes, Symptoms, and Treatment
    https://patient.info/childrens-health/impetigo-leaflet
    Impetigo is a skin infection. It is usually caused by a germ (bacterium). Often, one of the following three types of bacterial infection is responsible for impetigo: […] Staphylococcus aureus (the most common cause). […] Streptococcus pyogenes (also known as group A streptococcus). […] Meticillin-resistant Staphylococcus aureus (MRSA). This is a newer type of bacterium which has become resistant to many antibiotics. […] In primary impetigo, the infection affects healthy skin. […] In secondary impetigo, the infection affects skin that is already 'broken’ by other skin conditions. […] Impetigo commonly occurs in children but it can affect anyone at any age. […] You are more prone to develop impetigo if you have diabetes or if you have a weakened immune system (for example, if you are having chemotherapy). […] A possible cause for this is if the germ (bacterium) causing the infection is resistant to the prescribed cream or tablet. […] A possible cause for this is that the bacteria that cause the infection can sometimes live in (’colonise’) the nose.
  • #3
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4008061/
    Impetigo is a common cutaneous infection that is especially prevalent in children. Historically, impetigo is caused by either group A -hemolytic streptococci or Staphylococcus aureus. Currently, the most frequently isolated pathogen is S. aureus. […] The presence of maceration, humidity, previous skin lesions, obesity, corticosteroid or chemotherapy treatments, dysglobulinemias, leukocyte disorders such as leukemia and chronic granulomatous disease, diabetes, malnutrition, other congenital or acquired immunodeficiencies, such as AIDS, are predisposing factors. […] Several decades of epidemiological studies indicate that there are some strains of group A streptococci that elicit oropharyngeal infections, but rarely cause impetigo. On the other hand, there is a distinct group of strains that cause cutaneous infection but that do not affect the throat.
  • #3 Recurrent Impetigo: Causes And Management Strategies – Klarity Health Library
    https://my.klarity.health/recurrent-impetigo-causes-and-management-strategies/
    If your impetigo is recurrent, you should visit a healthcare professional who can perform a culture and susceptibility (CS) swab. This aims to identify the cause of recurrence, such as methicillin-resistant S. aureus (MRSA), which can live in the nasal cavities and cause impetigo to return after the initial infection has cleared. […] Recurrent impetigo is a common skin infection caused by bacteria entering a break in the skin. […] In the case of recurrent impetigo, bacteria may be living within your nasal cavities, lying dormant until a break in the skin allows for re-infection. A nasal swab can identify this as the cause, and subsequent use of nasal ointment should clear out the infection for good.
  • #3 Impetigo Contagious Symptoms, Causes & Infection Treatment
    https://www.medicinenet.com/impetigo/article.htm
    Impetigo is contagious and is caused by strains of both staph and strep bacteria. […] Impetigo (pronounced im-puh-TIE-go) is a contagious, superficial infection of the skin caused by Staphylococcus (staph) and Streptococcus (strep) bacteria. […] Impetigo is most likely to occur in warm and humid environments and is most commonly spread by close contact (such as between family members). […] Bacteria that cause impetigo may enter through a break in the skin, such as that which comes from cuts and scrapes. […] Heat, humidity, and the presence of eczema predispose a person to develop impetigo. […] Recurrent impetigo infections may be associated with staph or strep bacteria residing in the nose and spreading to other parts of the skin. […] The incubation period (the time between exposure to the bacteria and the first development of symptoms) depends on the infective bacteria. Strep-caused impetigo has a shorter incubation period (one to three days) than staph-caused impetigo (four to 10 days).
  • #3 Impetigo: Diagnosis and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0815/p229.html
    Impetigo is the most common bacterial skin infection in children two to five years of age. […] Nonbullous impetigo, or impetigo contagiosa, is caused by Staphylococcus aureus or Streptococcus pyogenes, and is characterized by honey-colored crusts on the face and extremities. […] Impetigo is a common bacterial skin infection caused by Staphylococcus aureus, group A beta-hemolytic Streptococcus pyogenes, a combination of the two, or less commonly, anaerobic bacteria. […] Other factors that predispose to impetigo are skin trauma; hot, humid climates; poor hygiene; day care settings; crowding; malnutrition; and diabetes mellitus or other medical comorbidities. […] The highly contagious nature of impetigo also allows spread from patients to close contacts. […] The number of possible causes, incidence, and clinical severity of acute poststreptococcal glomerulonephritis have decreased, because the causative organism of impetigo has shifted from S. pyogenes to S. aureus.
  • #4 Impetigo: Diagnosis and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0815/p229.html
    There are no data to indicate that antibiotic treatment of impetigo has any effect on preventing the development of acute poststreptococcal glomerulonephritis, which can occur in up to 5% of patients with nonbullous impetigo. […] The incidence of MRSA-related skin and soft tissue infections was increasing, but more recent studies show it may be declining. […] If MRSA infection is suspected, initial treatment with trimethoprim/sulfamethoxazole, clindamycin, or a tetracycline (doxycycline or minocycline [Minocin]) is recommended pending culture results.