a Inserm, CIC 1408, I-REIVAC , University Hospital of Saint-Etienne , Saint-Etienne , France.
b GIMAP EA 3064 , University of Lyon , Saint-Etienne , France.
Expert Rev Vaccines. 2018 May;17(5):421-433. doi: 10.1080/14760584.2018.1470507. Epub 2018 May 7.
In spite of the widespread implementation of preventive strategies, the prevalence of healthcare-associated infections (HAIs) remains high. HAIs are associated with multidrug resistant organisms, and in the post-antibiotic era, alternative strategies such as vaccines are needed for their management.
Vaccines to prevent HAIs could be proposed to at-risk patients, or to healthcare workers (HCWs) to prevent cross-transmission. After searches in Pubmed and clinicaltrials.gov, existing vaccines and vaccines under clinical development are presented in this narrative review. Issues associated with the use of vaccines to prevent HAIs are discussed.
Future vaccines against HAIs will contribute to fight antibiotic resistance and thus reduce the burden of HAIs. At this stage, the goal of obtaining effective vaccines against S.aureus, C. difficile and gram-negative bacteria has not yet been achieved. Obtaining an efficient response to vaccines in at-risk patients for HAIs is also challenging, and future strategies of vaccination need to address this difficulty. The efficacy of vaccines for HCWs in reducing the spread of nosocomial outbreaks is counterbalanced by the lack of adherence to vaccine policies among HCWs. The acceptance of future vaccines to prevent carriage and infection with organisms involved in HAIs in HCWs will probably be a challenge.
尽管广泛实施了预防策略，但医疗保健相关感染（HAIs）的患病率仍然很高。HAIs 与多药耐药菌有关，在抗生素后时代，需要疫苗等替代策略来进行管理。
预防 HAIs 的疫苗可以针对高危患者或医疗保健工作者（HCWs）以防止交叉传播。在在 Pubmed 和 clinicaltrials.gov 进行搜索后，本叙述性综述介绍了现有的疫苗和正在临床开发中的疫苗。讨论了与使用疫苗预防 HAIs 相关的问题。
未来针对 HAIs 的疫苗将有助于对抗抗生素耐药性，从而降低 HAIs 的负担。在现阶段，尚未实现针对金黄色葡萄球菌、艰难梭菌和革兰氏阴性菌的有效疫苗的目标。在 HAIs 的高危患者中获得对疫苗的有效反应也是具有挑战性的，未来的疫苗接种策略需要解决这一难题。HCWs 接种疫苗以减少医院感染暴发传播的效果因 HCWs 对疫苗政策的不遵守而受到影响。未来预防与 HAIs 相关的生物体携带和感染的疫苗在 HCWs 中的接受度可能是一个挑战。
