Methicillin-resistant Staphylococcus aureus: A phantom or true menace in our neonates?

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important health care-associated pathogen, but community-acquired MRSA has emerged as a pathogen in children without established risk factors. S. aureus nasal carriage is a risk factor for infection in humans, particularly in hospitals, and appears to antedate bacteremic as well as non-bacteremic infection. A cross sectional study was implemented from July 2004 to 2006 in Mofid Children’s Hospital. Trained technicians obtained nasal swab samples from neonates. Questionnaires were completed for each and MRSA colonies were detected. One thousand and three hundred and sixty six neonates were included in this study. Age on admission had direct correlation with staphylococcus colonization. History of previous antibiotic consumption had an indirect relationship with nasal colonization. We did not find any correlation between MRSA colonization and different variables (such as birth weight, age, sex, history of antibiotic consumption). These predictors may help inform clinical decision making when starting empiric antibiotic therapy. First, older neonates admitted to the ward are more likely to be carriers of S. aureus. When clinicians encounter infections in this group, especially in areas of the body where staphylococcal infections are common, such as the skin, treatment should include an antibiotic that is effective against S. aureus. Fortunately, MRSA carriage rate is low in our neonates; therefore, clinicians should not start antibiotic therapy against MRSA until the presence of this organism is documented by laboratory methods.