Escherichia coli and Klebsiella vaccines and immunotherapy

A polyvalent vaccine has been prepared from the capsular polysaccharide of 24 different serotypes of Klebsiella spp. Nearly 200 volunteers have received this vaccine. It is very well tolerated and elicits both binding (ELISA) and functional antibody to 21 of 24 antigens. Antibodies were also detected against 10 serotypes not included in the vaccine. An immunoglobulin for intravenous use (IVIG) was more protective in mouse lethality assays and enhanced opsonophagocytic killing of bacteria more than standard, nonhyperimmune globulin. A monovalent E. coli conjugate vaccine against O18ac antigen was safe and highly immunogenic in humans. A 12-valent conjugate vaccine elicits good levels of antibody in rabbits, and will soon undergo phase I testing in humans. These vaccines might best be used for inducing antibody in donor plasma that could be made into IVIG for passive administration.