Bacterial Vaccines for Recurrent Urinary Tract Infections: A Systematic Review with Emerging Evidence in Kidney Transplant Recipients
Abstract
CONTEXT
Recurrent urinary tract infections (rUTIs) are a major cause of morbidity in both the general population and kidney transplant recipients (KTRs). With rising antimicrobial resistance, bacterial vaccines are being increasingly explored.
OBJECTIVE
This systematic review evaluates the efficacy and safety of Uromune and StroVac in adults with and without kidney transplantation.
EVIDENCE ACQUISITION
A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines. PubMed and Cochrane databases were searched for studies published from 2020 onward. Outcomes included urinary tract infection (UTI) recurrence, recurrence-free rates, antibiotic use, and adverse events, with subgroup analysis of KTRs.
EVIDENCE SYNTHESIS
A total of 11 studies (n = 3517) were included, comprising two randomized controlled trials and nine observational studies. Uromune demonstrated consistent reductions in UTI recurrence across all included studies. In the randomized controlled trial, median UTI episodes decreased from 6.0 to 0.0 compared with 6.0 to 3.0 in the placebo group (p < 0.001). Large observational studies also reported substantial reductions in recurrence rates. In contrast, evidence for StroVac was more heterogeneous. Although observational studies reported favorable outcomes, the only randomized controlled trial did not demonstrate superiority over placebo (p = 0.63). Evidence in KTRs was limited (n = 34), but both…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,517 participants or records.
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