Isolation and Identification of Methicillin-resistant Staphylococcus aureus in the Neonatal Intensive Care Unit of Zliten Medical Center

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a major concern in neonatal intensive care units (NICUs) due to its resistance to β-lactam antibiotics and its capacity to cause severe infections in vulnerable newborns. Objective: This study aimed to isolate and identify MRSA in the NICU of Zliten Medical Center, Libya, assess its prevalence among neonates, healthcare workers (HCWs), and equipment, and evaluate antimicrobial susceptibility patterns. Methods: A total of 140 samples were collected from March to May 2025, comprising swabs from neonates (n=80), HCWs (n=22), and medical equipment (n=38). Identification and antibiotic susceptibility testing (AST) were performed using standard microbiological methods and the BD Phoenix automated system. Results: MRSA was detected in 3.6% of total samples (5/140), including two isolates from neonates (2.5%), two from HCWs (9.0%), and one from equipment (2.7%). All isolates exhibited absolute resistance (100%) to β-lactams, while remaining fully susceptible (100%) to Vancomycin, Linezolid, Daptomycin, and Teicoplanin. Conclusion: The relatively low overall prevalence should not diminish the clinical significance of MRSA in high-risk populations, particularly given the higher colonization rate among staff. These findings underscore the necessity for continuous surveillance, stringent infection control measures, and antimicrobial stewardship programs in Libyan NICUs to protect neonates and prevent the spread of resistant pathogens.