Infection rates are falling
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 information will attract 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 code covers infection control, decontamination and cleanliness and the most recent data shows that a quarter of trusts failed to meet 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 resolve the difficulties. Fines should be a last resort."
The draft measures are out for consultation until the autumn.
As well as regulating hospitals, the new watchdog will have responsibility for overseeing care homes, GP surgeries and private facilities.
These responsibilities are currently divided up between several different bodies.