Methicillin resistant staphylococcus aureus infection in neonates- a major concern and a call for action

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is both a human commensal and a pathogen
that causes neonatal infection which is associated with significant morbidity and mortality. Its genetic flexibility
and versatility have equipped it with the ability to develop resistance to numerous antibiotics. Outbreaks of
infections in neonatal intensive care units as well as community infections have been reported mostly in developed
countries. However, there is a paucity of data on neonatal MRSA infection in developing countries. The study aims
to highlight cases of MRSA infection, describe the clinical presentation, and outline the antibiotic susceptibility
pattern among term neonates in our facility.
Methodology: It was a prospective cross-sectional hospital-based study carried out from October 2018 to July
2019. A total of 248 term neonates with suspected sepsis were enrolled in the study and had their blood samples
taken for investigations including blood culture. Bacterial identification and antibiotic susceptibility patterns were
carried out using MicrobactTM24E (Oxiod UK) and Staph ID and modified Kirby-Bauer disk diffusion technique
respectively.
Results: Out of the 248 subjects enrolled in the study, 34.2% had proven sepsis, with Staphylococcus species
accounting for 56.4% of these cases. Among those with staphylococcal sepsis, 56.3% were found to have MRSA
infection. Notably, the majority (94.4%) of cases originated from outside the hospital, presenting as neonatal sepsis
with non-specific clinical features. Sensitivity testing revealed that ciprofloxacin and chloramphenicol were the
most effective antibiotics against the identified pathogens.
Conclusion: The presence of MRSA infections in neonates poses a critical public health threat. This trend
underscores the emergence of antimicrobial resistance, potentially compromising treatment efficacy and
jeopardizing neonatal well-being. Urgent and decisive measures are necessary to curb this trajectory.