Technologies to support vaccine development against antimicrobial-resistant bacteria

Antimicrobial resistance (AMR) represents one of the most critical global health challenges of the twenty-first century. The emergence and spread of microorganisms that no longer respond to the available antibiotics has prompted the World Health Organization to call for renewed commitment and investments in the discovery and development of novel prophylactic and therapeutic strategies. In particular, vaccines can help reduce the incidence caused by antimicrobial-resistant pathogens, thereby decreasing the need for antibiotics and the risk of selecting resistant strains. Here we describe standard and innovative approaches to vaccine design starting from live-attenuated and killed whole-cell vaccines, going through the revolution represented by Reverse Vaccinology and recombinant DNA technologies, and finally ending with rational vaccine design allowed by monoclonal antibody discovery, structural biology, nanoparticles and mRNA biology. Overall, we expect that the recent major progress in vaccinology will enhance health protection and reduce the impact of the AMR phenomenon in high-income as well as in low- and middle-income countries. This article is part of the Royal Society Science+ meeting issue 'Vaccines and antimicrobial resistance: from science to policy'.