Pfizer Inc, 401 N. Middletown Road, Pearl River, NY 10965, USA.
Vaccine. 2013 Jun 7;31(25):2723-30. doi: 10.1016/j.vaccine.2013.04.002. Epub 2013 Apr 23.
Staphylococcus aureus is a leading cause of both healthcare- and community-associated infections globally. S. aureus exhibits diverse clinical presentations, ranging from benign carriage and superficial skin and soft tissue infections to deep wound and organ/space infections, biofilm-related prosthesis infections, life-threatening bacteremia and sepsis. This broad clinical spectrum, together with the high incidence of these disease manifestations and magnitude of the diverse populations at risk, presents a high unmet medical need and a substantial burden to the healthcare system. With the increasing propensity of S. aureus to develop resistance to essentially all classes of antibiotics, alternative strategies, such as prophylactic vaccination to prevent S. aureus infections, are actively being pursued in healthcare settings. Within the last decade, the S. aureus vaccine field has witnessed two major vaccine failures in phase 3 clinical trials designed to prevent S. aureus infections in either patients undergoing cardiothoracic surgery or patients with end-stage renal disease undergoing hemodialysis. This review summarizes the potential underlying reasons why these two approaches may have failed, and proposes avenues that may provide successful vaccine approaches to prevent S. aureus disease in the future.
金黄色葡萄球菌是全球范围内导致医疗保健相关和社区相关感染的主要原因。金黄色葡萄球菌表现出多种临床表现，从良性携带和浅表皮肤和软组织感染到深部伤口和器官/腔隙感染、生物膜相关假体感染、危及生命的菌血症和败血症。这种广泛的临床谱，加上这些疾病表现的高发生率以及不同风险人群的巨大规模，对医疗保健系统提出了很高的未满足的医疗需求和巨大的负担。由于金黄色葡萄球菌对几乎所有类别的抗生素的耐药性不断增加，因此在医疗保健环境中正在积极寻求替代策略，例如预防性疫苗接种以预防金黄色葡萄球菌感染。在过去的十年中，金黄色葡萄球菌疫苗领域在旨在预防接受心胸外科手术的患者或接受血液透析的终末期肾病患者的金黄色葡萄球菌感染的 3 期临床试验中出现了两次重大疫苗失败。这篇综述总结了这两种方法可能失败的潜在原因，并提出了可能为未来预防金黄色葡萄球菌疾病提供成功疫苗方法的途径。
