Epidemiology and antimicrobial resistance analysis of staphylococcus aureus isolated from women, children and neonates in a maternal and child specialty hospital in Southeast China

Staphylococcus aureus (S. aureus) is a common bacterium posing a significant global health threat, with methicillin-resistant S. aureus (MRSA) epidemiology varying widely by region, time period, and population. Moreover, antibiotic management strategies differ for vulnerable groups including neonates, children, and pregnant women. This study investigates the clinical distribution and antimicrobial resistance profiles of S. aureus isolates from a maternal-child specialty hospital, with a particular focus on MRSA epidemiology.

Herein, we retrospectively enrolled all non-duplicate S. aureus isolates recovered in our hospital from October 2020 to August 2024. All isolates were divided into three groups: neonates, children, and women, followed by an analysis of their clinical distributions. Antimicrobial susceptibility testing was conducted via broth microdilution or disk diffusion methods following Clinical and Laboratory Standards Institute (CLSI) criteria, with data analyzed using WHONET 5.6. The chi-square test, Fisher’s exact test, Monte Carlo method, and multivariate logistic regression were adopted for statistical analysis using R 4.2.2.

A total of 973 S. aureus isolates were studied, of which 65.6% were from inpatients and 28.4% from the neonatal unit. Sputum (37.3%, 363/973) and pus (24.2%, 235/973) were the predominant specimens, with relatively high proportions of isolates from the genital tract (10.3%) and intrauterine sites (6.2%). Of 732 isolates subjected to susceptibility testing, the overall MRSA detection rate was 19.7% (144/732). The risk of MRSA colonization or infection was higher in children (OR = 2.774, P = 0.0049) but lower in the obstetric population (OR = 0.0122, P = 0.0491). Significant differences in susceptibility rates to penicillin, erythromycin and clindamycin were observed among the three subgroups.

S. aureus isolates were predominantly obtained from neonates and lactating mothers, mainly from the lower respiratory tract and skin/soft tissue sites. The high proportion of genital tract and intrauterine colonization/infection may raise possible concerns regarding vertical mother-to-child S. aureus transmission. MRSA demonstrated a moderate overall prevalence, with children carrying a higher risk of MRSA infection or colonization. Collectively, these data underscore the need for sustained MRSA surveillance and age-specific, differentiated prevention strategies for these vulnerable groups.