In the fight against Staphylococcus aureus bacteria, and the increasing spread of resistant strains such as MRSA, vaccination of key target groups could provide a very useful tool for infection prevention, claims a new report.

The study, from Datamonitor, says that considerable efforts are being made to reduce infection rates, such as hand-hygiene programmes in hospitals, thorough disinfection of medical devices and isolation of infected patients. However, “their overall impact on infection rates has been limited thus far, and they are unlikely to remain efficacious in the long run”, notes the study, “particularly considering the rapid spread of S aureus in the community setting”.

In addition, the increasing emergence of resistant S aureus strains further reduces treatment options, according to Datamonitor vaccines senior analyst Hedwig Kresse. She notes that “several new antibiotics, which show good efficacy against S aureus and even MRSA have been launched in the last two years”, which means that good treatment options are available for the short- to mid-term future.

However, she argues that it is only a question of time until S aureus strains with resistance against the new drugs will emerge, “particularly since most of these compounds are either molecules from long-established drug classes” or closely related to older products. “Antibiotic treatment is essentially a selection race between drug developers and pathogens, whereas preventive strategies such as vaccines have the potential to overcome this cycle,” Ms Kresse added.

As a result, a prophylactic S aureus vaccine “could have a large commercial opportunity”, Datamonitor claims and companies including Nabi Biopharmaceuticals, Intercell/Merck & Co, VRi and Inhibitex/ Wyeth are developing candidates. However, vaccine design against S aureus is associated with significant challenges as populations at particularly high risk, may not respond sufficiently to vaccination due to their weakened immune status.

So immunisation is unlikely to be a ‘one-size-fits-all’ solution, but Ms Kresse says that the greatest chance of success involves “a prudent combination of vaccination, antibody-based prevention and transmission control measures as part of hospital hygiene strategies”.