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Abstract

Abstract Title

Bacterial Vaccines for Preventing Recurrent Urinary Tract Infections: A Systematic Review and Meta-Analysis

Presentation Type

Podium Abstract

Manuscript Type

Meta Analysis / Systematic Review

Abstract Category *

Infectious Disease / Urologic Trauma

Author's Information

Number of Authors (including submitting/presenting author) *

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Co-author 1

Omattage Mahasha Perera mahasha.perera@gmail.com Department of Urology, Ipswich Hospital Brisbane Australia *

Co-author 2

Yam Ting Ho mahasha.perera@gmail.com Department of Urology, Ipswich Hospital Brisbane Australia -

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Abstract Content

Introduction

Recurrent UTIs (rUTIs) are a significant global health challenge, mainly among women, causing substantial clinical and economic burdens. Standard treatment relies on antibiotics, which pose risks such as AMR and adverse effects. Bacterial vaccines have emerged as promising alternatives to reduce dependence on antibiotics and prevent rUTIs. This study aims to to provide a systematic review and meta-analysis on the effectiveness and safety of bacterial vaccines, compared to conventional treatments of antibiotics or placebo for prevention of rUTIs.

Materials and Methods

PubMed, Embase, and Web of Science databases were systematically searched to find studies on bacterial vaccines for rUTIs. The selection criteria included randomised controlled trials of adults with rUTIs using bacterial vaccines, control groups receiving placebo or antibiotics, and outcomes were UTI recurrence rates, adverse events, and follow-up duration. Cochrane RoB2 and ROBINS-I tools were used to evaluate the risk of bias. Meta-analysis was done by using a random-effects model.

Results

Sixteen studies were included which compared different bacterial vaccines. The highest pooled risk ratio (RR) was found with MV140, 2.1 (95% CI: 1.3–2.5), and the second one was the Uro-Vaxom with RR 1.9, 95% CI: 1.5–2.2, and third one is Uromune with the RR of 1.8, 95% CI: 1.4–2.2. Bacterial vaccines appear to be more effective in comparison with antibiotics, in a pooled RR of 2.7, 95% CI: 2.1–3.0. Adverse events were generally mild across the studies (size effect: 2.4, 95% CI: 1.16–2.14). Long-term follow-up (>12 months) revealed sustained vaccine efficacy (RR: 1.58, 95% CI: 0.65–1.47).

Conclusions

Bacterial vaccines are alternative, safe, and efficient ways to prevent rUTIs, reduce antibiotic use, and decrease the risk of AMR. Although some short-term benefits are shown, more high-quality, long-term trials are warranted to confirm long-term effects and optimize vaccination strategies. These results support the addition of bacterial vaccines to daily clinical practice to tackle these challenges sustainably.

Keywords

Recurrent urinary tract infections, bacterial vaccines, MV140, antimicrobial resistance, vaccine efficacy, UTI prevention, immunoprophylaxis.

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