CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France.
Faculty of Medicine, Université Jean Monnet St-Etienne, St-Etienne, France.
Clin Microbiol Rev. 2024 Sep 12;37(3):e0016022. doi: 10.1128/cmr.00160-22. Epub 2024 Aug 9.
SUMMARYHealthcare-associated infections (HAIs) represent a burden for public health with a high prevalence and high death rates associated with them. Pathogens with a high potential for antimicrobial resistance, such as ESKAPE pathogens ( and ) and , are responsible for most HAIs. Despite the implementation of infection prevention and control intervention, globally, HAIs prevalence is stable and they are mainly due to endogenous pathogens. It is undeniable that complementary to infection prevention and control measures, prophylactic approaches by active or passive immunization are needed. Specific groups at-risk (elderly people, chronic condition as immunocompromised) and also healthcare workers are key targets. Medical procedures and specific interventions are known to be at risk of HAIs, in addition to hospital environmental exposure. Vaccines or monoclonal antibodies can be seen as attractive preventive approaches for HAIs. In this review, we present an overview of the vaccines and monoclonal antibodies in clinical development for prevention of the major bacterial HAIs pathogens. Based on the current state of knowledge, we look at the challenges and future perspectives to improve prevention by these means.
摘要
医疗保健相关感染（HAIs）是公共卫生的负担，其发病率和死亡率都很高。具有高度抗微生物药物耐药性的病原体，如 ESKAPE 病原体（肠杆菌科、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和肠球菌）和耐碳青霉烯类肠杆菌科（CRE），是大多数 HAI 的罪魁祸首。尽管实施了感染预防和控制干预措施，但全球范围内 HAI 的发病率仍然稳定，主要是由于内源性病原体。不可否认的是，除了感染预防和控制措施外，还需要通过主动或被动免疫进行预防性方法。特定的高危人群（老年人、免疫功能低下的慢性病患者）和医疗保健工作者也是重点目标。除了医院环境暴露外，医疗程序和特定干预措施也被认为存在 HAI 的风险。疫苗或单克隆抗体可被视为预防 HAI 的有吸引力的方法。在这篇综述中，我们概述了用于预防主要细菌性 HAI 病原体的临床开发中的疫苗和单克隆抗体。基于当前的知识水平，我们探讨了通过这些方法改善预防的挑战和未来前景。
