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You can now get the latest PHP with mysqlnd (MySQL Native Driver) support via remis' yum repository as mentioned in PHP-5.3,-zts-and-mysqlnd. The blog mentions that this is enabld in php-zts. However, no php-pecl extension are available and neither are some of the extensions thread safe. So I went about rebuilding php package from source for mysqlnd support.

1. Download the source php rpm from http://rpms.famillecollet.com/SRPMS/ . Note, I have used php-5.3.2 which is the latest as of this writing.
   
2. Install and apply the below diff patch to the spec file via `patch -p0 < {new_patch_file}` where "new_patch_file" has the below contents:
   --- php-5.3.2-remi.spec.orig 2010-03-11 23:07:04.000000000 -0600
+++ php-5.3.2-remi.spec 2010-03-11 23:36:03.000000000 -0600
@@ -24,6 +24,7 @@
%global phpversion 5.3.2

# Optional components; pass "--with mssql" etc to rpmbuild.
+%define with_mysqlnd %{?_with_mysqlnd:1}%{!?_with_mysqlnd:0}
%define with_oci8 %{?_with_oci8:1}%{!?_with_oci8:0}
%define with_ibase %{?_with_ibase:1}%{!?_with_ibase:0}
%if %{?rhel}%{?fedora} > 4
@@ -677,6 +678,11 @@
%if %{?fedora}%{?rhel:99} >= 10
         --with-system-tzdata \
%endif
+%if %{with_mysqlnd}
+        --with-mysql=shared,mysqlnd \
+        --with-mysqli=shared,mysqlnd \
+        --with-pdo-mysql=shared,mysqlnd \
+%endif
$*
if test $? != 0; then
   tail -500 config.log
@@ -704,8 +710,13 @@
       --enable-dba=shared --with-db4=%{_prefix} \
       --with-xmlrpc=shared \
       --with-ldap=shared --with-ldap-sasl \
+%if %{with_mysqlnd}
+      --with-mysql=shared,mysqlnd \
+      --with-mysqli=shared,mysqlnd \
+%else
       --with-mysql=shared,%{_prefix} \
       --with-mysqli=shared,%{_bindir}/mysql_config \
+%endif
%ifarch x86_64
       %{?_with_oci8:--with-oci8=shared,instantclient,%{_libdir}/oracle/%{oraclever}/client64/lib,%{oraclever}} \
%else
@@ -725,7 +736,11 @@
       --enable-fastcgi \
       --enable-pdo=shared \
       --with-pdo-odbc=shared,unixODBC,%{_prefix} \
+%if %{with_mysqlnd}
+      --with-pdo-mysql=shared,mysqlnd \
+%else
       --with-pdo-mysql=shared,%{_prefix} \
+%endif
       --with-pdo-pgsql=shared,%{_prefix} \
       --with-pdo-sqlite=shared,%{_prefix} \
       --with-pdo-dblib=shared,%{_prefix} \
@@ -756,6 +771,16 @@
       --with-recode=shared,%{_prefix}
popd

+%if %{with_mysqlnd}
+without_shared="--without-gd \
+      --disable-dom --disable-dba --without-unixODBC \
+      --disable-xmlreader --disable-xmlwriter \
+      --without-sqlite \
+      --disable-phar --disable-fileinfo \
+      --disable-json --without-pspell --disable-wddx \
+      --without-curl --disable-posix \
+      --disable-sysvmsg --disable-sysvshm --disable-sysvsem"
+%else
without_shared="--without-mysql --without-gd \
       --disable-dom --disable-dba --without-unixODBC \
       --disable-pdo --disable-xmlreader --disable-xmlwriter \
@@ -764,6 +789,7 @@
       --disable-json --without-pspell --disable-wddx \
       --without-curl --disable-posix \
       --disable-sysvmsg --disable-sysvshm --disable-sysvsem"
+%endif

# Build Apache module, and the CLI SAPI, /usr/bin/php
pushd build-apache

3. Package with:
   

   rpmbuild -bb --with mysqlnd --define "rhel 5" SPECS/php-5.3.2-remi.spec
   

4. To install via yum, change to the directory where rpms are located and recreate the repodata via:
   
   createrepo .
5. Note: you may need to install some of the missing dependent devel packages. I used a combination of base, epel and remi repository to install the dependencies.