Use of vaccine in the era of antimicrobial resistance: Need of effective pneumococcal vaccines

Streptococcus pneumoniae is an important pathogen causing invasive infectio ns particularly in children. Penicillin-nonsusceptible pneumococci are very prevalent in Korea and a difficult problem in antimicrobial treatment. Imm unization with effective vaccines including viral and bacterial vaccines ha s proven to be the most effective and reliable method to prevent the target disease. Universal immunization to infants with Haemophilus influenzae typ e b conjugate vaccine has dramatically proven to be very effective in reduc ing invasive Hib diseases and also the carriage rate. The 23-valent pneumoc occal polysaccharide vaccine is effective in preventing invasive diseases i n young adults and covers most of the penicillin-nonsusceptible types. It h as not proven very effective in the prevention of otitis media, and is unab le to elicit adequate antibody response in children younger than 2 years of age. Recently a new polysaccharide-protein conjugate vaccine Mas developed which can elicit antibody response in children younger than 2 years of age . However, the vaccine is only 8-valent at the moment. Studies are required to determine the possible idiotypic modulation and nonproductive immune re sponse Ir hen polysaccharide vaccine is administered to infants. Part of th e problem of antimicrobial-resistant pneumococcal infection may be solved i n the future with the use of improved vaccine. Preventing pneumococcal infe ctions with safe and effective vaccines will not only reduce the developmen t of antibiotic resistance, but could also be the most cost-effective metho d to control pneumococcal disease.