Immunotherapeutic strategies to combat staphylococcal infections.

Antibiotic-resistant staphylococci are the leading cause of nosocomial infections in many hospitals around the world. Meanwhile, methicillin-resistant Staphylococcus aureus (MRSA) spread also in the community where highly virulent strains infect healthy adults that have no predisposing risk factors. Although a few novel antibiotics have been recently introduced into clinical practice, the search for alternative strategies to efficiently combat staphylococcal infections is urgently demanded to decrease the enormous burden caused by pathogenic staphylococci. In particular, immunological strategies based on vaccine development or therapeutic antibodies may significantly enhance the efficiency of anti-staphylococcal therapy. Most approaches are directed against surface components of staphylococci such as cell wall-linked adhesins, teichoic acids, capsule, the biofilm component PIA/PNAG, or soluble virulence determinants such as alpha-toxin, Panton-Valentine leukocidin, or superantigenic enterotoxins. Although 2 recent clinical trials have failed, several novel promising vaccines and therapeutic antibodies are currently in preclinical and clinical development.