The challenge of addressing AMR through effective prevention can be addressed in two ways, said Prof Kozlov, Chief Specialist to the Ministry of Health for the Russian Federation on Clinical Microbiology and Antimicrobial Resistance, and Head of the WHO Collaborating Centre for Capacity Building on Antimicrobial Resistance Surveillance and Research.
AMR can be addressed firstly through the development of new entities, for example new vaccines, new antimicrobials, alternative therapies such as antibodies and potentially bacteriophages. Secondly, AMR can be addressed through the development methods for AMR detection including genetics, genomics, proteomics and other digital sciences.
The role of vaccines in the prevention of disease is well understood, but Prof Kozlov advised that we also need to look at vaccines as a substantial and evidence-based tool to curb AMR. The use of a particular vaccine against a bacterial infection will lead to protection from this infection, thus reducing the need to use antimicrobials, and consequently reducing the potential for AMR. However, it is also important to understand that near universal vaccination creates herd immunity that can protect the community from the spread of resistant infections.
“What is often underestimated from the perspective of AMR is that even the use of vaccines, developed against viral diseases, can actually protect from super-infections, thus reducing the need for antimicrobials and again
reducing the risk of AMR,” he said. “Therefore vaccines are a key component in the fight against AMR both directly and indirectly.”
Although the ability to use vaccines for the prevention of AMR currently only exists for a small subset of bacterial and viral pathogens, Prof Kozlov expressed certainty that in the next couple of decades we will see new vaccines not only targeting the classical bacterial pathogens but also targeting multidrug resistant bacteria.
"We still have quite a road ahead of us, but we feel quite strongly that vaccines can be a key component in the fight against antimicrobial resistance."
Prof Roman Kozlov
To exemplify the contribution of vaccination, Prof Kozlov described the use of pneumococcal conjugated vaccines and the Haemophilus influenzae type B (Hib) vaccine. “The use of pneumococcal vaccines led not only to a reduction in both invasive and non-invasive pneumococcal infections, but also correlated directly with the reduction in AMRs,” he said. “Likewise, the introduction of Hib conjugated vaccines led to the virtual elimination of invasive Hib infections and crucially also the elimination of resistant Hib infections that were common in the 1980s.”