Hospitals which breach hygiene rules could be fined up to �50,000, the government is proposing.
Inspectors will also have powers to close dirty wards or clinics as part of the fight against superbugs in England.
They are part of new measures which could be given to the Care Quality Commission, the new watchdog replacing the Healthcare Commission next year.
It comes after Clostridium difficile and MRSA rates have dropped by nearly a third in the past year.
NHS trusts that fail to meet minimum hygiene standards will be issued with fixed penalty notices with fines of up to �4,000.
Obstructing an inspector or failing to provide documents or entropy will pull fines of �1,250.
While the most serious offences, such as failing to act on an improvement notice following an infection outbreak, could lead to a maximum �50,000 fine.
The hygiene computer code covers infection control, decontamination and cleanliness and the most late data shows that a quarter of trusts failed to get together at least one of the standards.
A Department of Health spokesman said: "This is a toughening up of the regulations around infection control.
But Jo Webber, of the NHS Confederation, which represents hospital bosses, said: "Where there are problems NHS trusts would hope that the commission would work with them to settle the difficulties. Fines should be a last resort."
The draft measures are extinct for consultation until the autumn.
As intimately as regulation hospitals, the new guard dog will have responsibility for overseeing concern homes, GP surgeries and private facilities.
These responsibilities ar currently divided up between several different bodies.
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