A conjugate vaccine can confer partial immunity against Staphylococcus aureus bacteremia for approximately 40 weeks in patients receiving haemodialysis.
After 40 weeks, protection wanes as antibody levels decrease.
These are the findings of a double blind, placebo-controlled study evaluating use of a conjugate vaccine containing the two most common capsular polysaccharides that confer virulence on Staphylococcus (S.) aureus.
Among the adults on long-term haemodialysis in this study, a single dose of the vaccine had an efficacy of 57 percent against S. aureus bacteremia from week three to week 40 after vaccination. S. aureus is a major cause of bacteremia and its complications in patients with decreased resistance to infection.
The capsular polysaccharides are essential for the pathogenesis of and immunity to S. aureus infection and are targets for vaccines.
In this trial, researchers evaluated the safety, immunogenicity and efficacy of a vaccine with S. aureus type five and eight capsular polysaccharides conjugated to nontoxic recombinant Pseudomonas aeruginosa exotoxin A.
Henry Shinefield and colleagues from the Kaiser Permanente Vaccine Study Center, Oakland, California headed this multicentre United States study.
Participants were 1,804 adult patients at 73 different US centres; all were on haemodialysis. Between April 1998 and August 1999, researchers randomly assigned these patients to receive a single intramuscular injection of either vaccine or saline.
IgG antibodies to S. aureus type five and eight capsular polysaccharides were measured for up to two years and episodes of S. aureus bacteremia recorded.
Researchers estimated efficacy by comparing the incidence of S. aureus bacteremia in the patients who received the vaccine with the incidence in the control patients.
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