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KMID : 1039120210100020081
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Clinical and Experimental Vaccine Research
2021 Volume.10 No. 2 p.81 ~ p.92
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Impact of vaccination on carriage of and infection by antibiotic-resistant bacteria: a systematic review and meta-analysis
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Wang Li Min
Hashiguchi Tiago Cravo Oliveira
Cecchini Michele
Michele Cecchini
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Abstract
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This systematic review and meta-analysis aims to quantify the impact of vaccination on the incidence and prevalence of nonsusceptible infections and investigates the impact of vaccination programs on serotype replacement. We searched a comprehensive set of databases. Identified studies were assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach and resulting evidence was analyzed using random-effect meta-analyses. Nineteen studies on pneumococcal conjugate vaccines (PCV) met our inclusion criteria. PCV decreases the incidence of nonsusceptible pneumococcal infections (PIs) by 56.91% (95% confidence interval [CI], ?50.90% to ?62.91%) and the probability of carriage of nonsusceptible pneumococcal bacteria by 28.10% (95% CI, ?13.25% to ?42.95%). The effect of PCV on PIs becomes higher when only serotypes specifically targeted by the vaccine are taken into account (?80.98%; 95% CI, ?70.34% to ?91.52%), while it becomes lower when all the PIs, including both susceptible and nonsusceptible PIs, are considered (?48.30%; 95% CI, ?31.55% to ?65.08%). The effect of PCV is found greater in populations with high prevalence of human immunodeficiency virus and for PCV covering a higher number of serotypes. Findings from this study suggest that vaccination programs may be an effective tool to prevent the spread of PIs and may play a significant role in tackling antimicrobial resistance.
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KEYWORD
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Streptococcus pneumoniae, Drug resistance, Vaccination, Systematic review, Meta-analysis
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