---
title: "MRSA in Vietnamese NICUs: Epidemiology, Treatment, and Control Strategies for Neonates"
id: "pubmed-42687663"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42687663"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42687663/"
doi: "10.1080/14787210.2026.2726969"
published_at: "2026-09-03T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# MRSA in Vietnamese NICUs: Epidemiology, Treatment, and Control Strategies for Neonates
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42687663
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42687663/)
- **DOI:** [10.1080/14787210.2026.2726969](https://doi.org/10.1080%2F14787210.2026.2726969)
- **Published At:** 2026-09-03T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Vietnam has a high burden of **methicillin-resistant Staphylococcus aureus (MRSA)** in neonates, but neonatal-specific data on epidemiology, resistance, treatment, and prevention are limited and fragmented across regions and healthcare settings. - National data indicate MRSA constitutes about **73% of Staphylococcus aureus** isolates, with notable regional variation in distribution and resistance patterns. - Widespread antibiotic overuse is a major driver of resistance: approximately **67.4% of hospitalized patients** receive antibiotics, and up to **90% of pediatric prescriptions** are considered inappropriate. - **Vancomycin** remains the first-line treatment for severe MRSA infections in neonates; alternative agents (linezolid, daptomycin, ceftaroline, clindamycin, and adjunctive rifampin) have limited roles and must be considered based on local susceptibility. - Local antibiograms are essential to guide therapy because alternatives have constrained indications and variable activity. - Optimizing vancomycin dosing with **AUC-guided dosing**, therapeutic drug monitoring, and timely de-escalation is critical to maximize efficacy while limiting toxicity. - The emergence and spread of vancomycin-resistant organisms (notably vancomycin-resistant enterococci reported up to 34%) threaten the sustainability of last-line treatments. - Effective MRSA control strategies include infection prevention bundles, surveillance cultures, targeted decolonization, and implementation of **antimicrobial stewardship programs** tailored to Vietnam’s healthcare context. - The review identifies key knowledge gaps and prioritizes clinical practice changes, stewardship initiatives, and targeted research to support more effective MRSA management and control in neonatal intensive care units (NICUs) in Vietnam.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Methicillin resistant staphylococcus aureus treatment and control in neonates: lessons learned - a Vietnam perspective [Jennifer Le](https://pubmed.ncbi.nlm.nih.gov/?term=Le+J&cauthor_id=42687663)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#full-view-affiliation-1 "University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#full-view-affiliation-2 "Center on International Pharmacy Education and Research, University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA."), [Tavin Sayles](https://pubmed.ncbi.nlm.nih.gov/?term=Sayles+T&cauthor_id=42687663)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#full-view-affiliation-1 "University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA."), [Duy Kieu Nguyen](https://pubmed.ncbi.nlm.nih.gov/?term=Nguyen+DK&cauthor_id=42687663)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#full-view-affiliation-3 "Hanoi Obstetrics and Gynecology Hospital Hanoi, Vietnam."), [Anh Viet Nguyen](https://pubmed.ncbi.nlm.nih.gov/?term=Nguyen+AV&cauthor_id=42687663)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#full-view-affiliation-4 "Vietnam National Children's Hospital, Hanoi, Vietnam."), [Ha Thu Vu](https://pubmed.ncbi.nlm.nih.gov/?term=Vu+HT&cauthor_id=42687663)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#full-view-affiliation-5 "Saint Paul Hospital, Hanoi, Vietnam."), [Nga Thi Bich Nguyen](https://pubmed.ncbi.nlm.nih.gov/?term=Nguyen+NTB&cauthor_id=42687663)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#full-view-affiliation-6 "Children's Hospital #1, Ho Chi Minh City, Vietnam."), [Dua Thi Nguyen](https://pubmed.ncbi.nlm.nih.gov/?term=Nguyen+DT&cauthor_id=42687663)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#full-view-affiliation-5 "Saint Paul Hospital, Hanoi, Vietnam.") Affiliations Expand ### Affiliations * 1 University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA. * 2 Center on International Pharmacy Education and Research, University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA. * 3 Hanoi Obstetrics and Gynecology Hospital Hanoi, Vietnam. * 4 Vietnam National Children's Hospital, Hanoi, Vietnam. * 5 Saint Paul Hospital, Hanoi, Vietnam. * 6 Children's Hospital #1, Ho Chi Minh City, Vietnam. * PMID: **42687663** * DOI: [ 10.1080/14787210.2026.2726969 ](https://doi.org/10.1080/14787210.2026.2726969) Item in Clipboard Review # Methicillin resistant staphylococcus aureus treatment and control in neonates: lessons learned - a Vietnam perspective Jennifer Le et al. Expert Rev Anti Infect Ther. 2026. Show details Display options Display options Format Abstract PubMed PMID Expert Rev Anti Infect Ther Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Expert+Rev+Anti+Infect+Ther%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Expert+Rev+Anti+Infect+Ther%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42687663/) . 2026 Sep 3. doi: 10.1080/14787210.2026.2726969. Online ahead of print. ### Authors [Jennifer Le](https://pubmed.ncbi.nlm.nih.gov/?term=Le+J&cauthor_id=42687663)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#short-view-affiliation-1 "University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#short-view-affiliation-2 "Center on International Pharmacy Education and Research, University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA."), [Tavin Sayles](https://pubmed.ncbi.nlm.nih.gov/?term=Sayles+T&cauthor_id=42687663)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#short-view-affiliation-1 "University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA."), [Duy Kieu Nguyen](https://pubmed.ncbi.nlm.nih.gov/?term=Nguyen+DK&cauthor_id=42687663)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#short-view-affiliation-3 "Hanoi Obstetrics and Gynecology Hospital Hanoi, Vietnam."), [Anh Viet Nguyen](https://pubmed.ncbi.nlm.nih.gov/?term=Nguyen+AV&cauthor_id=42687663)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#short-view-affiliation-4 "Vietnam National Children's Hospital, Hanoi, Vietnam."), [Ha Thu Vu](https://pubmed.ncbi.nlm.nih.gov/?term=Vu+HT&cauthor_id=42687663)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#short-view-affiliation-5 "Saint Paul Hospital, Hanoi, Vietnam."), [Nga Thi Bich Nguyen](https://pubmed.ncbi.nlm.nih.gov/?term=Nguyen+NTB&cauthor_id=42687663)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#short-view-affiliation-6 "Children's Hospital #1, Ho Chi Minh City, Vietnam."), [Dua Thi Nguyen](https://pubmed.ncbi.nlm.nih.gov/?term=Nguyen+DT&cauthor_id=42687663)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42687663/#short-view-affiliation-5 "Saint Paul Hospital, Hanoi, Vietnam.") ### Affiliations * 1 University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA. * 2 Center on International Pharmacy Education and Research, University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA. * 3 Hanoi Obstetrics and Gynecology Hospital Hanoi, Vietnam. * 4 Vietnam National Children's Hospital, Hanoi, Vietnam. * 5 Saint Paul Hospital, Hanoi, Vietnam. * 6 Children's Hospital #1, Ho Chi Minh City, Vietnam. * PMID: **42687663** * DOI: [ 10.1080/14787210.2026.2726969 ](https://doi.org/10.1080/14787210.2026.2726969) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Introduction:** Vietnam bears a substantial burden of methicillin-resistant Staphylococcus aureus (MRSA), yet neonatal data on epidemiology, antimicrobial resistance, treatment, and prevention remain limited and fragmented across regions and healthcare settings. **Areas covered:** This review summarizes MRSA epidemiology, risk factors, treatment, and prevention in neonatal intensive care units (NICUs), identifies key knowledge gaps, and highlights priorities for clinical practice, antimicrobial stewardship, and future research to support more effective management and control strategies. MRSA comprises 73% of S. **Aureus:** isolates nationally, with notable regional variation. Antibiotic overuse is common, affecting roughly 67.4% of hospitalized patients, and up to 90% of pediatric prescriptions are inappropriate, driving resistance. Vancomycin remains the first-line therapy for severe MRSA infections. Alternative agents - including linezolid, daptomycin, ceftaroline, clindamycin, and adjunctive rifampin - have limited roles, underscoring the importance of local antibiogram-guided therapy. **Expert opinion:** Optimizing vancomycin use through AUC-guided dosing, therapeutic drug monitoring, and de-escalation is critical to balance efficacy and toxicity. Although MRSA remains largely susceptible to vancomycin, the emergence of vancomycin-resistant enterococci (up to 34%) threatens last-line treatment sustainability. Effective strategies to reduce MRSA burden include infection prevention bundles, surveillance cultures, targeted decolonization, and antimicrobial stewardship programs. These interventions must be tailored to Vietnam's healthcare. **Keywords:** MRSA; antimicrobial resistance; infants; limited-resource country; neonatal intensive care unit; staphylococcus aureus. 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