CHSU Discovery

Abstract:

The prevalence of Staphylococcus aureus infections in the postoperative setting, particularly in joint arthroplasties, presents a persistent challenge worldwide. Despite the use of various antibiotic regimens as the primary treatment approach, the escalating antibiotic resistance displayed by S. aureus prolongs hospital stays and contributes to further medical complications. Thus, given the lack of efficacy of the current antibiotic prophylactic approach, there is growing promise in pursuing pre-operative vaccinations as a robust alternative to antibiotics. This review examines the efficacy of immunological interventions aimed at preventing postoperative S. aureus infections, with a focus on application of vaccines in reducing complications, hospital stays, and overall cost-effectiveness. Relevant articles were identified through keyword searches regarding the effectiveness of vaccination strategies for S. aureus infections in postoperative settings. Recent studies highlight the potential of a 4-antigen S. aureus vaccine SA4Ag, currently being evaluated in patients undergoing spinal fusion surgery. Early-phase studies have demonstrated the safety of this vaccine and its ability to induce significant bactericidal antibodies in patients prior to surgery. Additionally, S. aureus vaccine rFSAV (Olymvax), composed of 5 recombinant S. aureus antigens, has shown efficacy in targeting the bacteria's immune evasion mechanisms in mice experiments. Implementation of vaccine-based pretreatment modalities for surgical patients, even with vaccines demonstrating modest efficacy rates of 70%, could potentially prevent 127,364 cases of S. aureus infections and avert the deaths of 2,234 patients annually. While significant challenges remain in the development and implementation of human vaccines for S. aureus infections, vaccines offer a compelling alternative to improve operative outcomes and mitigate the risks, complications, and potential fatalities associated with S. aureus infections.