Abstract

Acinetobacter baumannii is a Gram-negative, opportunistic pathogen that causes nosocomial infection with a high mortality rate in immunocompromised individuals. With the frequent emergence of multidrug-resistant A. baumannii strains that have rapidly gained resistance to most antibiotics, an extensive search for an effective A. baumannii vaccine is ongoing. Over the decade, many subunit vaccine candidates were identified using reverse vaccinology and in vivo animal studies for validation. Nineteen subunit vaccine candidates with a wide range of efficacy, from 14% to 100% preclinical survival rates, were included in this review. This article provides an updated review of several outer membrane proteins (Omp) that emerged as vaccine candidates with great potential, including OmpA, Omp34, Omp22 and BamA, based on their high conservancy, antigenicity, and immune protection against A. baumannii infection. However, there is still no licenced A. baumannii vaccine currently due to several practical issues that have yet to be resolved, such as inconsistencies between validation studies, antigen variability and insolubility. Moving forward, much investigation and innovation are still required to tackle these challenges for the regulatory approval of an A. baumannii subunit vaccine, including standardisation of immunisation study parameters, improving antigen solubility and the incorporation of nucleic acid vaccine technology.

摘要

鲍曼不动杆菌是一种革兰氏阴性机会致病菌，可引起免疫功能低下个体的院内感染和高死亡率。随着对大多数抗生素迅速产生耐药性的多重耐药鲍曼不动杆菌菌株的频繁出现，对有效的鲍曼不动杆菌疫苗的广泛研究正在进行中。十年来，利用反向疫苗学和体内试验鉴定了许多候选亚单位疫苗动物研究进行验证。本次评价纳入了 19 种候选亚单位疫苗，它们具有广泛的功效，临床前存活率从 14% 到 100%。本文对几种具有巨大潜力的候选疫苗外膜蛋白 (Omp) 进行了最新综述，包括 OmpA、Omp34、Omp22 和 BamA，它们具有高度保守性、抗原性和针对鲍曼不动杆菌感染的免疫保护作用。然而，目前仍没有获得许可的鲍曼不动杆菌目前，疫苗存在一些尚未解决的实际问题，例如验证研究之间的不一致、抗原变异性和不溶性。展望未来，鲍曼不动杆菌亚单位疫苗的监管批准仍需要大量研究和创新来应对这些挑战，包括免疫研究参数的标准化、提高抗原溶解度和核酸疫苗技术的结合。