Clin Exp Vaccine Res.  2021 May;10(2):81-92. 10.7774/cevr.2021.10.2.81.

Impact of vaccination on carriage of and infection by antibiotic-resistant bacteria: a systematic review and meta-analysis

• Wang LM
• Oliveira Hashiguchi TC
• Cecchini M

• KMID: 2525794
• DOI: http://doi.org/10.7774/cevr.2021.10.2.81

Abstract

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.

Keyword

Streptococcus pneumoniae; Drug resistance; Vaccination; Systematic review; Meta-analysis