Vaccines: Do they have a role in orthopedic trauma?

Although vaccines have been hailed as one of the greatest advances in medicine based on their unparalleled cost-effectiveness in eradicating life-threatening infectious diseases, their role in orthopedic trauma-related infections is unclear. This is largely because vaccines are primarily made against pathogens that cause communicable diseases rather than opportunistic infections secondary to trauma, and most successful vaccines are against viruses rather than biofilm forming bacteria. Nonetheless, the tremendous costs to patients and healthcare systems warrant orthopedic trauma vaccine research, which has been a focal topic in recent international consensus meetings on musculoskeletal infection. This subject was also covered at the 2023 Osteosynthesis and Trauma Care Foundation (OTCF) meeting in Rome, Italy, and the purpose of this supplement article is to (1) highlight the osteoimmunology, animal models, translational research and clinical pilots that were discussed, (2) the proposed future directions that could lead to diagnostics and prognostics that are critically needed for evidence-based decision making, and (3) vaccines and passive-immunization strategies that could potentially be utilized to treat patients with orthopedic infections.

尽管疫苗因其在根除危及生命的传染病方面具有无与伦比的成本效益而被誉为医学上最伟大的进步之一，但其在骨科创伤相关感染中的作用尚不明确。这在很大程度上是因为疫苗主要是针对引起传染病的病原体而不是创伤继发的机会性感染研制的，而且大多数成功的疫苗是针对病毒而非形成生物膜的细菌。然而，患者和医疗保健系统所承担的巨大成本使得骨科创伤疫苗研究成为必要，这也是近期关于肌肉骨骼感染的国际共识会议的重点议题。这个主题在2023年于意大利罗马举行的骨结合与创伤护理基金会（OTCF）会议上也有所涉及，而这篇补充文章的目的是：（1）强调所讨论的骨免疫学、动物模型、转化研究和临床试验；（2）提出可能通向基于证据决策所急需的诊断和预后方法的未来方向；（3）介绍可能用于治疗骨科感染患者的疫苗和被动免疫策略。