tetracycline and Tularemia

Because of the recent lack of availability of streptomycin--currently considered the drug of choice for the treatment of tularemia--we reviewed the literature on alternative drugs that have been used for this purpose. In addition, we reviewed data on the in vitro susceptibility of Francisella tularensis to a wide variety of agents. The rate of cure for streptomycin was 97%, with no relapses. For gentamicin and tetracycline, respectively, the rates of cure were 86% and 88%, the rates of relapse were 6% and 12%, and the rates of failure were 8% and 0. The duration of therapy with gentamicin and a delay in its initiation may have affected outcome in severe cases. For chloramphenicol and tobramycin, cure rates were 77% and 50%, respectively; relapse rates were 21% and 0; and failure rates were 2% and 33%, respectively. Treatment with imipenem/cilastatin was successful in one case, and that with ciprofloxacin or norfloxacin was successful in six cases; in contrast, therapy with ceftriaxone was ineffective in eight cases. On the basis of this review, we conclude that gentamicin is an acceptable alternative to streptomycin for the treatment of tularemia.

Topics: Francisella tularensis; Gentamicins; Humans; Microbial Sensitivity Tests; Streptomycin; Tetracycline; Tularemia

Topics: Adolescent; Adult; Aged; Animals; Cat-Scratch Disease; Child; Child, Preschool; Disease Outbreaks; Female; Fever; Gastroenteritis; Humans; Indians, North American; Insect Vectors; Leukemia; Lymphogranuloma Venereum; Male; Middle Aged; New Mexico; Phagocytosis; Plague; Rodentia; Sciuridae; Siphonaptera; Streptomycin; Syphilis; Tetracycline; Tularemia; Yersinia pestis

Francisella tularensis is a Gram-negative intracellular pathogen causing tularemia. A number of its potential virulence factors have been identified, but their biology and functions are not precisely known. Understanding the biological and immunological functions of these proteins requires adequate genetic tools for homologous and heterologous expression of cloned genes, maintaining both original structure and post-translational modifications. Here, we report the construction of a new multipurpose shuttle plasmid - pEVbr - which can be used for high-level expression in F. tularensis. The pEVbr plasmid has been constructed by modifying the TetR-regulated expression vector pEDL17 (LoVullo, 2012) that includes (i) a strong F. tularensis bfr promoter, and (ii) two tet operator sequences cloned into the promoter. The cloned green fluorescent protein (GFP), used as a reporter, demonstrated almost undetectable basal expression level under uninduced conditions and a highly dynamic dose-dependent response to the inducer. The utility of the system was further confirmed by cloning the gapA and FTT_1676 genes into the pEVbr vector and quantifying proteins expression in F. tularensis LVS, as well as by studying post-translational modification of the cloned genes. This study demonstrates that high levels of recombinant native-like Francisella proteins can be produced in Francisella cells. Hence, this system may be beneficial for the analysis of protein function and the development of new treatments and vaccines.

Topics: Francisella tularensis; Humans; Plasmids; Recombinant Proteins; Tetracycline; Tularemia

Tularaemia is a zoonotic disease caused by the bacterium Francisella tularensis. In Germany, the disease is still rare (e.g. 34 human cases reported in 2015). There is a lack of data about the susceptibility of F. tularensis strains to antibiotics, because many cases are diagnosed using serological assays only.. The antibiotic susceptibility in vitro of F. tularensis subsp. holarctica strains isolated in Germany was assessed to determine whether the currently recommended empirical therapy is still adequate.. A total of 128 F. tularensis strains were investigated that were collected between 2005 and 2014 in Germany from wild animals, ticks and humans. All isolates were genotyped using real-time PCR assays targeting canonical SNPs, and antibiotic susceptibility was tested using MIC test strips on agar plates. MIC values were interpreted using CLSI breakpoints.. The strains were susceptible to antibiotics commonly recommended for tularaemia therapy, i.e. aminoglycosides (MIC90 values: gentamicin 1 mg/L; streptomycin 4.0 mg/L), tetracyclines (MIC90 values: tetracycline 0.5 mg/L; doxycycline 1.5 mg/L) and quinolones (MIC90 value: ciprofloxacin 0.064 mg/L). Chloramphenicol (MIC90 value: 3.0 mg/L) may be of value in treatment of tularaemia meningitis. Ninety-four isolates were susceptible to erythromycin, which defines biovar I (genotypes B.4 and B.6); 34 were resistant (biovar II; genotype B.12).. The F. tularensis isolates investigated in this study showed the typical antibiotic susceptibility pattern that was previously observed in other countries. Therefore, recommendations for empirical antibiotic therapy of tularaemia can remain unchanged. However, antibiotic susceptibility testing of clinical isolates should be performed whenever possible.

Topics: Animals; Animals, Wild; Anti-Bacterial Agents; Ciprofloxacin; Doxycycline; Foxes; Francisella tularensis; Genotype; Germany; Humans; Microbial Sensitivity Tests; Raccoons; Real-Time Polymerase Chain Reaction; Rodentia; Tetracycline; Ticks; Tularemia

Tularemia is a zoonotic disease of the northern hemisphere. Oculoglandular tularemia is the rarest form, comprising 1.4-4.2% of all cases. We present a patient with oculoglandular tularemia that did not respond to gentamicin to demonstrate the need for prolonged antimicrobial treatment and surgical intervention.

Topics: Adolescent; Anti-Bacterial Agents; Eye Infections, Bacterial; Gentamicins; Humans; Lymph Nodes; Lymphatic Diseases; Magnetic Resonance Imaging; Male; Masseter Muscle; Neck; Parotid Gland; Streptomycin; Tetracycline; Treatment Outcome; Tularemia

Due to concern that Francisella tularensis, the causative agent of tularemia, may be used as a bioterrorist weapon, the Clinical and Laboratory Standards Institute recently provided a susceptibility testing method with breakpoints. Here, 169 isolates (92 type A and 77 type B) from North America were tested against seven antimicrobial agents (streptomycin, gentamicin, tetracycline, doxycycline, ciprofloxacin, levofloxacin, and chloramphenicol) used for the treatment of tularemia. The MICs for all of the isolates fell within the susceptible range. In addition, all isolates had MICs for erythromycin of 0.5 to 4 microg/ml, in contrast to an MIC of >256 microg/ml for the common laboratory strain LVS (live vaccine strain).

Topics: Anti-Bacterial Agents; Francisella tularensis; Humans; Microbial Sensitivity Tests; North America; Tularemia

The antibiotic susceptibilities of 50 Francisella tularensis subsp. holarctica biovar II strains isolated from hares and human patients from the eastern part of Austria were examined. Minimum inhibitory concentrations (MICs) of 24 antimicrobial agents were determined using Eteststrade mark on cysteine heart agar plates supplemented with 10% sheep blood. All isolates were sensitive to tetracyclines, aminoglycosides, quinolones, chloramphenicol and rifampicin. Resistance was observed in all isolates against macrolides, penicillins and aztreonam. Bacteria were resistant to cephalosporins and carbapenems, except for 8% of strains investigated that were susceptible or intermediately susceptible. Our in vitro susceptibility data can be applied for the detection and comparison of resistance development and to provide in vitro data for the guidance of therapy.

Topics: Aminoglycosides; Animals; Anti-Bacterial Agents; Antibiotics, Antitubercular; Austria; Carbapenems; Cephalosporins; Chloramphenicol; Francisella tularensis; Hares; Humans; Microbial Sensitivity Tests; Quinolones; Rifampin; Tetracycline; Tularemia

Topics: Disease Outbreaks; Humans; Newfoundland and Labrador; Tetracycline; Tularemia

Topics: Adult; Eye Infections, Bacterial; Fluorescein Angiography; Fundus Oculi; Gentamicins; Humans; Male; Tetracycline; Tularemia; Visual Acuity

Topics: Animals; Child; Child, Preschool; Female; Francisella tularensis; Humans; Male; Rabbits; Tetracycline; Tularemia

A 60-year-old man had pyogenic meningitis due to Francisella tularensis acquired by tick bite. His disease initially improved but later relapsed after a standard course of streptomycin. Complete resolution resulted from prolonged combined therapy with streptomycin and tetracycline. Successful treatment of acute tularemic meningitis has not previously been reported. Our experience suggests that therapy should include agents that reliably penetrate the CSF, that is, tetracycline or chloramphenicol, for optimal treatment of this rare form of tularemia.

Topics: Acute Disease; Chloramphenicol; Drug Therapy, Combination; Humans; Male; Meningitis; Middle Aged; Streptomycin; Tetracycline; Tularemia

Topics: Adolescent; Agglutination Tests; Animals; Arvicolinae; Disease Outbreaks; Disease Vectors; Francisella tularensis; Humans; Lymph Nodes; Male; Quebec; Streptomycin; Tetracycline; Tularemia

Topics: Agglutination Tests; Bites and Stings; Body Temperature; California; Child; Humans; Louisiana; Male; Tetracycline; Ticks; Tularemia; Urban Population

Topics: Animals; Azauridine; Drug Synergism; Guinea Pigs; Streptomycin; Tetracycline; Tularemia

Topics: Adult; Canada; Female; Humans; Male; Ontario; Tetracycline; Time Factors; Tularemia; United States

Topics: Animals; Bites and Stings; Humans; Rodentia; Streptomycin; Tetracycline; Ticks; Tularemia

Topics: Adolescent; Adult; Aged; Animals; Child; Disease Outbreaks; Disease Vectors; Female; Fluorescent Antibody Technique; Francisella tularensis; Hemagglutination Tests; Humans; Lymphadenitis; Male; Middle Aged; Penicillins; Rodentia; Skin Ulcer; Streptomycin; Tetracycline; Tularemia; Vermont; Water Pollution; Zoonoses

Topics: Adult; Agglutination Tests; Amino Acids; Fever; Humans; Male; Respiratory Tract Infections; Tetracycline; Tularemia

Topics: Culicidae; Humans; Insect Vectors; Sweden; Tetracycline; Tularemia

Topics: Air Microbiology; Animals; Anti-Bacterial Agents; Haplorhini; Humans; Male; Tetracycline; Tularemia

Topics: Adult; Agglutination Tests; Conjunctivitis; Female; Humans; Hungary; Skin Tests; Streptomycin; Tetracycline; Tularemia

Topics: Humans; Kanamycin; Middle Aged; Streptomycin; Tetracycline; Tularemia

Topics: Agglutination; Animals; Anti-Bacterial Agents; Arthropod Vectors; Chloramphenicol; Dihydrostreptomycin Sulfate; Epidemiology; Finland; Mice; Protein Synthesis Inhibitors; Rabbits; Skin Tests; Streptomycin; Tetracycline; Ticks; Tularemia; Zoonoses

Topics: Animals; Anti-Bacterial Agents; Chloramphenicol; Czechoslovakia; Drug Therapy; Lagomorpha; Mice; Protein Synthesis Inhibitors; Rabbits; Streptomycin; Tetracycline; Tularemia; Zoonoses

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Immunity; Kanamycin; Mice; Mononuclear Phagocyte System; Pharmacology; Protein Synthesis Inhibitors; Research; Streptomycin; Tetracycline; Tularemia

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Chloramphenicol; Czechoslovakia; Dermatologic Agents; Eye Manifestations; Humans; Lymphadenitis; Protein Synthesis Inhibitors; Streptomycin; Tetracycline; Tularemia

Topics: Anti-Bacterial Agents; Dermatologic Agents; Humans; Tetracycline; Tularemia

Topics: Animals; Anti-Bacterial Agents; Dihydrostreptomycin Sulfate; Mice; Protein Synthesis Inhibitors; Tetracycline; Tularemia