Molecular Epidemiology, Clinical Manifestations, Decolonization Strategies, and Treatment Options of...

Area of Science:

• Neonatal infectious diseases
• Microbiology
• Public health

Background:

• Methicillin-susceptible Staphylococcus aureus (MSSA) is a prevalent pathogen in neonatal intensive care units (NICUs).
• Neonatal colonization rates reach 42.8%, with healthcare personnel also acting as carriers, facilitating nosocomial transmission.
• MSSA contributes to approximately 12% of neonatal S. aureus bloodstream infections, carrying a mortality risk up to 20.5%.

Purpose of the Study:

• To review the molecular characteristics, epidemiology, risk factors, and clinical aspects of MSSA infections in neonates.
• To analyze current decontamination strategies and treatment options for MSSA in newborns.
• To highlight the importance of surveillance and prevention for reducing MSSA-related morbidity and mortality.

Main Methods:

• Comprehensive literature review of MSSA in neonatal populations.
• Analysis of genetic heterogeneity, pathogenicity genes, and virulence factors of MSSA strains.
• Evaluation of epidemiological data, risk factors, clinical presentations, and treatment outcomes.

Main Results:

• MSSA exhibits significant genetic diversity with various sequence types (STs) and Staphylococcal Protein A types (SpA).
• Pathogenicity genes (hemolysins, superantigens, PVL) and biofilm-associated genes contribute to infection severity and persistence.
• Prematurity, low birth weight, prolonged hospitalization, and invasive devices are key risk factors. Active surveillance and decolonization reduced infections by up to 73%.

Conclusions:

• MSSA poses substantial risks in NICUs, necessitating targeted interventions.
• β-lactam antibiotics are the primary treatment, with aminoglycosides for severe cases.
• Genomic surveillance and preventive strategies are crucial for managing MSSA in neonates.