Bacterial Vaccines for the Management of Recurrent Urinary Tract Infections: A Systematic Review and Meta-analysis

Area of Science:

• Urology
• Immunology
• Infectious Diseases

Background:

• Recurrent urinary tract infections (rUTIs) pose a significant socioeconomic burden.
• Prophylactic antibiotics are commonly used but have limitations.
• Bacterial immunizations are being developed as an alternative prevention strategy.

Purpose of the Study:

• To systematically review the effectiveness of vaccinations in preventing rUTIs in adult patients.
• To evaluate the short-term and long-term efficacy of available vaccines.

Main Methods:

• Systematic literature search of Medline, Embase, and Web of Science up to December 2023.
• Included cohort studies with comparator arms and randomized controlled trials (RCTs).
• Pooled analysis of RCTs and narrative synthesis of other studies; assessed risk of bias and quality of evidence.

Main Results:

• Fourteen studies with 2822 patients across five vaccine types were analyzed.
• Pooled analysis of 8 RCTs showed a risk ratio of 1.52 (95% CI 1.05-2.20) for short-term UTI-free status (6-12 months).
• Number needed to treat was 6.45; substantial heterogeneity and potential publication bias were noted.

Conclusions:

• Limited evidence suggests short-term effectiveness of vaccinations in reducing rUTIs in adult women.
• Low quality of evidence necessitates further large-scale, long-term RCTs with standardized definitions.
• Conclusive evidence on long-term efficacy requires more robust research.