自动疫苗免疫预防在患有神经性膀,经历了反复发作的尿路感染的患者
Miguel Ángel Bonillo-García1, Domingo Guzmán Ordaz-Jurado1, Juan Ortiz-Salvador1
1Sección de Urología Reconstructiva y Funcional, Servicio de Urología, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Frontiers in immunology
|August 18, 2025
概括
自动接种疫苗显著减少了神经性膀患者的住院和急诊,这些患者患有复发性尿路感染 (UTI). 这种个性化免疫疗法为这种脆弱人群的慢性尿路感染管理提供了抗生素的有希望的替代品.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 神经性膀 (NB) 患者经常患有复发性尿路感染 (UTI),导致住院治疗和过度使用抗生素.
- 现有的预防措施,如长期抗生素,由于细菌耐药性和有效性有限,往往被证明是无效的.
- 自动接种疫苗,一种个性化免疫疗法,已显示出预防尿路感染的潜力,但缺乏在NB人群中进行广泛的研究.
研究的目的:
- 评估自动接种在减少患有神经性膀和复发性尿路感染的成年患者住院和急诊的疗效.
- 评估自动接种疫苗对无尿路感染的持续时间和患者报告的结果的影响.
- 探索自动接种作为一种可行的替代方案,用于NB相关的复发性尿路感染的常规抗生素预防.
主要方法:
- 一项前性,单中心研究,涉及71名成年NB患者,有复发性尿路感染史,对预防性抗生素没有反应.
- 参与者接受了从他们自己的尿病原体中制备的语言下细菌自动疫苗.
- 主要终点包括住院和急诊率的变化;次要终点包括无尿路感染时间和患者报告的结果.
主要成果:
- 自动接种导致住院病例 (1.76 至 0.78,p < 0.001) 和急诊病例 (8.62 至 3.93,p < 0.001) 的显著减少.
- 在治疗后3个月,6个月,9个月和12个月的无尿路感染率分别为69.1%,42.6%,29.4%和20.6%.
- 大多数患者报告自动接种疫苗后的高满意度和感知到的临床改善.
结论:
- 语言下自动接种是减少神经性膀患者复发性尿路感染发生率的有希望的策略.
- 治疗表明患者满意度高,医疗保健利用率显著降低.
- 进一步进行大规模的多中心试验是有必要的,以确认疗效,并为这一患者群建立最佳的治疗方案.
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