From Antibiotic Resistance to Bacterial Vaccines: A New Approach to Controlling Resistant Bacterial Infections

Feiyang Xiong,1,2,* Xiayi Fang,1,* Yanping Lu,3 Wenliang Lv2 1Hunan University of Chinese Medicine, Changsha, Hunan, People’s Republic of China; 2Department of Infection, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China; 3Department of Hepatology, Shenzhen Bao’an District Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yanping Lu, Department of Hepatology, Shenzhen Bao’an District Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China, Tel +8613973195144, Email 1171932654@qq.com Wenliang Lv, Department of Infection, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China, Tel +8619267490697, Email 754774067@qq.comAbstract: Antimicrobial resistance (AMR) is one of the major threats to global health, with a complex and diverse underlying mechanism. Vaccines reduce the dependence on antimicrobial agents by preventing and treating bacterial and viral infections, as well as secondary infections caused by both, thereby lowering the risk of AMR. Unlike traditional antibiotics, bacterial vaccines trigger a long-lasting immune response that not only prevents bacterial infections but also inhibits the spread of resistant strains. They show significant advantages in reducing antibiotic use and lowering resistance risks. However, the development of bacterial vaccines faces several challenges, including the diversity of bacterial antigens, rapid evolution, and the difficulty of achieving broad-spectrum immune protection. Despite these challenges, advancements in vaccine technology and the optimization of delivery systems are making the application prospects of bacterial vaccines in combating resistant strains increasingly promising. We sequentially discuss resistance mechanisms, existing and emerging vaccine platforms, enabling technologies, and future perspectives.Keywords: antimicrobial resistance, bacterial vaccines, bacterial infections, challenges, technolog