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肺炎克雷伯菌的疫苗价值概况。

Vaccine value profile for Klebsiella pneumoniae.

作者信息

Dangor Ziyaad, Benson Nicole, Berkley James A, Bielicki Julia, Bijsma Merijn W, Broad Jonathan, Buurman Ed T, Cross Alan, Duffy Erin M, Holt Kathryn E, Iroh Tam Pui-Ying, Jit Mark, Karampatsas Konstantinos, Katwere Michael, Kwatra Gaurav, Laxminarayan Ramanan, Le Doare Kirsty, Mboizi Robert, Micoli Francesca, Moore Catrin E, Nakabembe Eve, Naylor Nichola R, O'Brien Seamus, Olwagen Courtney, Reddy Denasha, Rodrigues Charlene, Rosen David A, Sadarangani Manish, Srikantiah Padmini, Tennant Sharon M, Hasso-Agopsowicz Mateusz, Madhi Shabir A

机构信息

South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa.

Global Health Division, Bill & Melinda Gates Foundation, Seattle, WA, USA.

出版信息

Vaccine. 2024 Jul 25;42(19S1):S125-S141. doi: 10.1016/j.vaccine.2024.02.072. Epub 2024 Mar 19.

Abstract

Klebsiella pneumoniae causes community- and healthcare-associated infections in children and adults. Globally in 2019, an estimated 1.27 million (95% Uncertainty Interval [UI]: 0.91-1.71) and 4.95 million (95% UI: 3.62-6.57) deaths were attributed to and associated with bacterial antimicrobial resistance (AMR), respectively. K. pneumoniae was the second leading pathogen in deaths attributed to AMR resistant bacteria. Furthermore, the rise of antimicrobial resistance in both community- and hospital-acquired infections is a concern for neonates and infants who are at high risk for invasive bacterial disease. There is a limited antibiotic pipeline for new antibiotics to treat multidrug resistant infections, and vaccines targeted against K. pneumoniae are considered to be of priority by the World Health Organization. Vaccination of pregnant women against K. pneumoniae could reduce the risk of invasive K.pneumoniae disease in their young offspring. In addition, vulnerable children, adolescents and adult populations at risk of K. pneumoniae disease with underlying diseases such as immunosuppression from underlying hematologic malignancy, chemotherapy, patients undergoing abdominal and/or urinary surgical procedures, or prolonged intensive care management are also potential target groups for a K. pneumoniae vaccine. A 'Vaccine Value Profile' (VVP) for K.pneumoniae, which contemplates vaccination of pregnant women to protect their babies from birth through to at least three months of age and other high-risk populations, provides a high-level, holistic assessment of the available information to inform the potential public health, economic and societal value of a pipeline of K. pneumoniae vaccines and other preventatives and therapeutics. This VVP was developed by a working group of subject matter experts from academia, non-profit organizations, public-private partnerships, and multi-lateral organizations, and in collaboration with stakeholders from the WHO. All contributors have extensive expertise on various elements of the K.pneumoniae VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using only existing and publicly available information.

摘要

肺炎克雷伯菌可导致儿童和成人社区获得性感染及医疗保健相关感染。2019年,全球估计分别有127万例(95%不确定区间[UI]:91万 - 171万)和495万例(95% UI:362万 - 657万)死亡归因于细菌抗菌药物耐药性(AMR)并与之相关。肺炎克雷伯菌是归因于AMR耐药菌死亡的第二大主要病原体。此外,社区获得性感染和医院获得性感染中抗菌药物耐药性的上升是对侵袭性细菌性疾病高危的新生儿和婴儿的一个担忧。用于治疗多重耐药感染的新抗生素研发渠道有限,针对肺炎克雷伯菌的疫苗被世界卫生组织视为优先事项。孕妇接种肺炎克雷伯菌疫苗可降低其幼儿侵袭性肺炎克雷伯菌病的风险。此外,患有潜在疾病(如因潜在血液系统恶性肿瘤、化疗导致免疫抑制)、正在接受腹部和/或泌尿系统外科手术或长期重症监护管理的肺炎克雷伯菌病高危脆弱儿童、青少年和成人人群也是肺炎克雷伯菌疫苗的潜在目标群体。肺炎克雷伯菌的“疫苗价值概况”(VVP)考虑对孕妇进行疫苗接种,以保护其婴儿从出生到至少三个月大以及其他高危人群,对现有信息进行了高层次、全面的评估,以告知肺炎克雷伯菌疫苗及其他预防和治疗方法的潜在公共卫生、经济和社会价值。该VVP由来自学术界、非营利组织、公私合营伙伴关系和多边组织的主题专家工作组制定,并与世卫组织的利益相关者合作。所有贡献者在肺炎克雷伯菌VVP的各个要素方面都有广泛的专业知识,并共同旨在识别当前的研究和知识差距。VVP仅使用现有和公开可用的信息制定。

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