Novel targeted immunotherapy approaches for staphylococcal infection

Importance of the field: Staphylococcus aureus is a leading human pathogen in the hospital and the community. Many S. aureus strains are resistant to antibiotics, making treatment of S. aureus infections often very complicated. In contrast to many other bacterial pathogens, a working vaccine has never been found for S. aureus despite considerable efforts in academia and pharmaceutical companies. Areas covered in this review: The latest strategies aimed at finding a working vaccine against S. aureus, including active and passive immunization efforts in pre-clinical and clinical stages, and the molecular reasons for why it may be difficult to develop a vaccine are discussed. What the reader will gain: In addition to receiving an overview of current efforts in S. aureus vaccine research, the reader will understand that vaccine development for S. aureus may be difficult owing to the facts that S. aureus is a commensal microorganism and produces toxins that lyse white blood cells, thereby undermining a vaccine's role as a facilitator of opsonophagocytosis. Take home message: As a result of failed clinical trials with monovalent traditional vaccines, recent developments include a shift towards the potential use of polyvalent formulas and therapeutic antibodies and more systematic selection of optimal antigens.