Molecular Epidemiology Clinical Manifestations, Decolonization Strategies and Treatment Options of Methicillin-Susceptible Staphylococcus aureus Infection in Neonates

Methicillin-sensitive Staphylococcus aureus (MSSA) infection continues to be a significant public health issue in neonatal intensive care units (NICUs). Although the research mostly focuses on methicillin-resistant Staphylococcus aureus (MRSA), new data reveal that methicillin-sensitive Staphylococcus aureus (MSSA) infections are three to four times more prevalent in neonates, correlating with increased mortality and morbidity. This study analyzes the molecular attributes, epidemiology, risk factors, clinical presentations, decontamination methods, and treatment alternatives for MSSA infections in newborns. Results demonstrate that MSSA strains possess considerable genetic diversity, as they are distinguished by a wide variety of sequence types (STs) and Staphylococcal Protein A types (SpA) and harbor several pathogenicity genes, including hemolysins and superantigens, which are implicated in severe infections, such as necrotizing pneumonia in PVL-positive strains. The epidemiological load is still high over the globe, and more newborns, parents, and healthcare workers are being colonized. Prematurity, low birth weight, lengthy hospitalization and the use of intrusive technologies are some of the biggest risk factors. Clinical signs include skin and soft tissue infections, bacteremia, and sepsis, with severe consequences such as endocarditis. Decolonization procedures using mupirocin and chlorhexidine have shown efficacy, but constrained by escalating resistance. In terms of treatment, β-lactams are still the best option. Cefazolin and isoxazolylpenicillins work better than vancomycin in clinical results. For a limited time, they may also be used with aminoglycosides for severe infections. In conclusion, MSSA infections in newborns are as perilous as MRSA, necessitating enhanced monitoring, the implementation of focused prevention strategies, and the development of novel treatment methods to mitigate morbidity and death in this susceptible population.