[A program for prevention of pseudomonas infections and immunoprophylaxis with PSAEVA vaccine]

The authors present three main trends of prevention of Gram-negative opportunistic infections investigated at the Cardiosurgical Clinic of the Institute of Clinical and Experimental Medicine. An important part is played by active and systematic surveillance with early signalling and analysis of new infections with subsequent aimed interventions against concrete sources of infection and mechanisms of transmission. It is necessary to think more of activation of endogenous infection the specific features of which make repression difficult and motivate investigations of preventive approaches. Rational antibiotic policy has so far not appreciated the danger of selection of endogenous and exogenous agents in standard situations where antibiotic therapy lacks an aimed and restrained approach. Immunoprophylaxis with the PSAEVA vaccine in the first preliminary controlled clinical investigation was characterized by the absence of nosocomial epidemics and septicaemia and a significant (fivefold) reduction of the incidence of non-pyocyanic Gram-negative bacteriaemia. The success of vaccination seems to be related to the anti-colonization and anti-invasive mechanism of specific and unspecific nature.