Global incidence of Acinetobacter baumannii. Need for an alternative solution to antibiotics.

In the European Union and the USA there are 2 and 1.7 million cases of hospital-acquired infections every year, respectively, linked to 275,000 deaths per year and an associated cost of 10 billion US dollars.

The bacterial pathogens causing these infections, which in many cases are resistant to several or all of the available antibiotics, fall within those represented by the acronym ESKAPE, which stands for: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.

Acinetobacter baumannii is directly responsible for 295,000 infections every year in the USA, 4% of all antibiotic-resistant infections in the EU, 9% of all hospital-acquired pneumonias, and 4% of all sepsis cases. The mortality rate of Acinetobacter’s pneumonia is 40%, while the mortality rate of sepsis caused by Acinetobacter is 60%.

Although the figures regarding Acinetobacter baumannii’s incidence in EU and USA are well known thanks to the precise reporting of the centers of disease control of the administration of these regions, multi-drug and pan-drug resistant Acinetobacter baumannii strains are causing significant morbidity and mortality all over the world. Recent reports published in specialized journals have shown the need of an alternative solution to antibiotics in all emerging countries, including Russia, Brazil, Chile, China, India, and the Middle East.

For illustration of the incidence in emerging countries, these are the conclusions of reports recently published about India and China:

In India, 70% of newborns who developed infections after birth were affected by antibiotic-resistant bacteria. Only in 2013, 500,000 Indian newborns developed either pneumonia or sepsis produced mainly by Klebsiella pneumoniae or Acinetobacter baumannii, killing 58,000.

In China, 1.6 million people develop sepsis caused by multi-drug resistant bacteria, resulting in 1.2 million deaths per year. And 640,000 people develop hospital-acquired pneumonia, resulting in 200,000 deaths. Acinetobacter baumannii is the direct cause of 17% of all those infections.

Finally, a very specific target population of a preventive vaccine against Acinetobacter baumannii is military personnel, specially the troops mobilized to war zones. The US Army has been significantly affected by infections produced by antibiotic-resistant strains of Acinetobacter baumannii and is very interested in preventive solutions.

The preventive vaccine VXD-001 might be distributed for preventions programs targeting a population of between 7 million people (only considering hospital admissions of people that might enroll in a vaccination program in the EU and USA) and 70 million people per year (adding up all major healthcare settings affected globally and the army). Economic studies support a price for each treatment between 500 and 1000 US dollars.

Pseudomonas aeruginosa is also a major cause of nosocomial infections, and similar to A. baumannii, increasing rates of antibiotic resistance over the last two decades have med the treatment of these infections difficult. The U.S. Centers for Disease Control and Prevention estimate that in the U.S. alone there are 51,000 infections caused by P. aeruginosa every year, resulting in hundreds of deaths. Pseudomonas aeruginosa is also a major cause of morbidity and mortality in patients with cystic fibrosis and chronic obstructive pulmonary disease (COPD).