A Shot at Urinary Tract Infection Prevention: Lessons from Global Use of UTI Vaccines

Abstract (English)

Background: Urinary Tract Infections (UTIs) are the second most common infectious disease globally. In the United States, UTIs continue to pose a particular threat to female adult populations, with a lifetime incidence of 50-60% in adult women. The current primary treatment regimen for UTIs is antibiotic therapy; however, the growing prevalence of antimicrobial resistance, especially among Escherichia coli (E. coli) strains, is contributing to therapeutic failure and related complications. Considering this growing challenge, the exploration of alternative therapeutic strategies for UTIs, especially vaccine-based interventions, has become increasingly important.

Objectives: To evaluate how UTI vaccine-based immunoprophylaxis, compared with standard non-vaccine prevention strategies, affects UTI recurrence rates, antibiotic use, and healthcare utilization based on international data, and to assess the implications for U.S. clinical practice.

Design: Systematic literature review

Methods: The National Library of Medicine PubMed database was searched using terms including “UTI vaccine” and “recurrent UTI treatment.” A variety of exclusion and inclusion criteria were incorporated and ultimately 3 studies were selected. These studies were analyzed for outcomes and validity assessments were conducted.

Results: Study #1: up to 9.4-fold increase in antibody titers against all targeted serotypes, significant reduction in UTIs caused by E. coli of any serotype (0.207 vs 0.463 episodes, p = 0.002) Study #2: significant reduction in UTIs (3.14 vs 0.84 episodes, p < 0.001) Study #3: significant reduction in UTIs (3.14 vs 1.53 episodes, p < 0.05)

Conclusion: The current international evidence suggests that UTI vaccine-based immunoprophylaxis demonstrates promising reductions in infection recurrence and reliance on antibiotics. These findings highlight the potential role of vaccine strategies in addressing recurrent UTIs while helping to mitigate antimicrobial resistance. Further research and large-scale studies are needed to determine the applicability of these interventions within U.S. clinical practice.