{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T18:43:20Z","timestamp":1771526600426,"version":"3.50.1"},"reference-count":70,"publisher":"The Royal Society","issue":"1944","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Sepsis is a leading cause of morbidity and mortality among newborns in low- and middle-income countries, and its treatment is further complicated by high rates of antimicrobial resistance to current antibiotics. We assessed the economic impact of a proposed maternal vaccine to protect neonates against sepsis caused by Klebsiella pneumoniae in 107 low- and middle-income countries. We estimated vaccine-avertable medical expenditures, vaccine-avertable productivity losses owing to caregiver absenteeism from work, and vaccine-avertable monetized disability-adjusted life-years using a country-specific value of statistical life-year estimate. Implementing a maternal K. pneumoniae vaccine could avert US$6.9 billion (95% CI 5.6\u20138.3) in monetized disability-adjusted life-years annually across 107 countries. Countries in the African region displayed the highest median vaccine-avertable medical costs and productivity losses per capita associated with resistance to first- and second-line treatments compared with other regions. Low-income countries were disproportionately impacted by the increased medical expenditures associated with antimicrobial resistance, with the median price of third-line antibiotic treatment in these countries being 23.9 days of income. Our estimates indicate that a maternal K. pneumoniae vaccine could significantly reduce the societal economic burden and catastrophic health expenditures for families affected by neonatal sepsis and antimicrobial resistance in low- and middle-income countries.<\/jats:p>\n                  <jats:p>This article is part of the Royal Society Science+ meeting issue \u2018Vaccines and antimicrobial resistance: from science to policy\u2019.<\/jats:p>","DOI":"10.1098\/rstb.2025.0002","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T08:27:28Z","timestamp":1771489648000},"source":"Crossref","is-referenced-by-count":2,"title":["Economic impact of a maternal\n                    <i>Klebsiella pneumoniae<\/i>\n                    vaccine: estimates for 107 low- and middle-income countries"],"prefix":"10.1098","volume":"381","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6596-4908","authenticated-orcid":false,"given":"Isabella","family":"Impalli","sequence":"first","affiliation":[{"name":"One Health Trust 1 , , ,","place":["Washington, DC, USA, 20015"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erta","family":"Kalanxhi","sequence":"additional","affiliation":[{"name":"One Health Trust 1 , , ,","place":["Washington, DC, USA, 20015"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7047-1717","authenticated-orcid":false,"given":"Harry Ronan","family":"Street","sequence":"additional","affiliation":[{"name":"One Health Trust 1 , , ,","place":["Washington, DC, USA, 20015"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chirag K.","family":"Kumar","sequence":"additional","affiliation":[{"name":"One Health Trust 1 , , ,","place":["Washington, DC, USA, 20015"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1390-9016","authenticated-orcid":false,"given":"Ramanan","family":"Laxminarayan","sequence":"additional","affiliation":[{"name":"One Health Trust 1 , , ,","place":["Washington, DC, USA, 20015"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"175","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"2026021903272436500_R1","unstructured":"World Health Organization\n          . 2020Global report on the epidemiology and burden of sepsis: current evidence, identifying gaps and future directions. 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