Klebsiella_transmission_and_immunity_on_Chatinkha_nursery__Neo_TRACK_

As treatment of KPn has become increasingly difficult, attention has turned to methods of prevention instead. One such strategy would be a KPn vaccine delivered to mothers to give their infants passive immunity in the first months of life, whilst they are most vulnerable. There is currently no vaccine against KPn, and it is not known which targets would offer protection. However, developing a vaccine based on surface exposed structures such as the O-antigen is most likely to be effective. A second potential method would be to identify infants most at risk of KPn infection and managing them with alternative first-line antibiotic therapy such as carbapenems, rather than waiting for the culture to become positive, as delay in starting therapy is dangerous. Lastly, we should identify the most important areas for targeting of infection prevention and control (IPC) measures based on the important modes of transmission. For each of these potential interventions (an O-antigen vaccine, empirical carbapenem therapy for high-risk infants and IPC strategies) whether they will work and how they should be deployed is uncertain due to a limited knowledge base. We see quality improvement in all three areas as being essential to improving outcomes and this study will improve the knowledge base in these three areas so that interventions aimed at prevention can be developed in an evidence-based manner.