Abstract
Recognition that immunisation might affect antimicrobial resistance is increasing. Many traditional bacterial vaccines continue to be effective, without the generation and expansion of bacterial escapee subpopulations, suggesting that vaccines deployed to control antimicrobial resistant bacteria are likely to be effective for substantially longer than are novel antimicrobials.1,2 The WHO list for antimicrobial resistance priority pathogens contains several bacteria for which there are no licensed vaccines or any vaccine development activity by big pharmaceutical companies (appendix p 1).
Highlights
Recognition that immunisation might affect antimicrobial resistance is increasing
Carbapenemresistant Acinetobacter baumannii is treatable only with colistin and, with 8500 cases and 700 associated deaths in the USA in 2017, has been identified as an urgent threat by the US Center for Disease Control and Prevention.[5]. This pathogen is widespread in Europe; as of 2018, more than 50% of the A baumannii isolated in Italy, Greece, Croatia, and Poland were carbapenem resistant and treatable only with colistin.[6]
The potential for an increased number of people who require intubation in intensive care units (ICUs) because of COVID-19, and are at possible risk of carbapenem-resistant A baumannii and other bacterial infections related to antimicrobial resistance, is truly terrifying and has not been addressed
Summary
Recognition that immunisation might affect antimicrobial resistance is increasing. Many traditional bacterial vaccines continue to be effective, without the generation and expansion of bacterial escapee subpopulations, suggesting that vaccines deployed to control antimicrobial resistant bacteria are likely to be effective for substantially longer than are novel antimicrobials.[1,2] The WHO list for antimicrobial resistance priority pathogens contains several bacteria for which there are no licensed vaccines or any vaccine development activity by big pharmaceutical companies (appendix p 1).[3,4] Among these pathogens, carbapenemresistant Acinetobacter baumannii is treatable only with colistin (ie, a last-resort antimicrobial) and, with 8500 cases and 700 associated deaths in the USA in 2017, has been identified as an urgent threat by the US Center for Disease Control and Prevention.[5]. Protecting intubated patients from the threat of antimicrobial resistant infections with monoclonal antibodies The presence of carbapenem-resistant A baumannii in a hospital setting, within intensive care units (ICUs), in which it affects patients who are intubated for mechanical ventilation, is a major concern.
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