Innocent Neonate, Resistant Staph, and Embarrassed Staff

which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial The neonatal period is the time when a human being is most vulnerable to bacterial infections such as Staphylococcus au-reus, which is a major pathogen causing neonatal morbidity and mortality. Staphylococci, aerobic or facultative anaerobic gram-positive bacteria, are able to survive in usual hospital environments, such as on fomites, in dust, on the surfaces of various materials. S. aureus can asymptomatically colonize the anterior nares, pharynx, skin, nails, axillae, perineum, and vagina. S. aureus is a major pathogen in early-and late-onset neonatal infection, and especially in nosocomial infections. The spread of S. aureus from a mother can cause fetal infection and consequent premature delivery, intrauterine growth restriction, or persistent infection in the newborn. Coloniza-tion of S. aureus in the maternal genital tract can result in infection of the fetus in utero or of the neonate intrapartum,or may simply lead to colonization of the infant. Thereafter, colonized S. aureus in a newborn may cause localized infections and/or bacteremia. Premature infants are more vulnerable to staphylococcal infection due to undeveloped host defense mechanisms, the presence of catheters, skin-interrupting procedures , prolonged total parenteral nutrition, and steroid treatments [1]. After strains of S. aureus resistant to methicillin (MRSA) were first identified [2], those strains emerged as an important nosocomial pathogen. MRSA isolates are resistant to the peni-cillinase-resistant penicillin class of antibiotics, such as methi-cillin, nafcillin, oxacillin, cloxacillin, and dicloxacillin, due to their production of a penicillin-binding protein (PBP), PBP2a, which has a low affinity for ß-lactams [3]. However, the spectrum of clinical diseases is similar between methicillin-susceptible S. aureus (MSSA) and MRSA, with the exception of bone or joint infections, which have been reported to be less likely to be caused by MRSA [4]. Colonization rates of S. aureus have been observed to be higher in people with skin diseases, drug abusers, those with indwelling intravenous catheters, and healthcare workers. Many of outbreaks of S. aureus in neonates have been associated with medical personnel who are colonized [5]. Recently, whole-genome sequencing has begun to be used to track and define transmission pathways to elucidate neonatal MRSA outbreaks [6]. Additionally, environmental antibiotic pressure may increase the prevalence of MRSA in nurseries. In one