New Threats from an Old Foe: Methicillin-Resistant Staphylococcus aureus Infections in Neonates

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a ubiquitous human inhabitant and one of the important pathogens of neonatal infections. MRSA is associated with significant mortality and morbidity, especially in very immature preterm neonates. Moreover, MRSA may be implicated in adverse long-term neonatal outcomes, posing a substantial disease burden. Recent advances in molecular microbiology have shed light on the evolution of MRSA population structure and virulence factors, which may contribute to MRSA epidemic waves worldwide. Equipped with remarkable genetic flexibility, MRSA has successfully developed resistance to an extensive range of antibiotics including vancomycin, as well as antiseptics. In the face of these new challenges from MRSA, our armamentarium of anti-infective strategies is very limited and largely dependent on prevention measures. Active surveillance cultures followed by decolonization may be a promising approach to control MRSA infections, with its efficacy and safety in the specific population of neonates yet to be addressed by large multicenter studies.

Keywords: Infection control; Methicillin-resistant Staphylococcus aureus; Molecular typing; Neonatal infections; Preterm infants.

Fig. 1.

Predominant methicillin-resistant Staphylococcus aureus clones that have been reported in neonatal infections so far. The given MRSA strains were isolated at one or more neonatal wards in the particular country. ST, sequence type.