Tularemic Meningitis in the United States

Hofinger, Diedre; Cardona, Luzma; Mertz, Grégory; Davis, Larry E.

doi:10.1001/archneurol.2009.14

Cited by 38 publications

(33 citation statements)

References 37 publications

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“…Chloramphenicol has been used occasionally (alone or in combination with other antibiotics) to treat patients with tularaemia meningitis, owing to its high distribution in brain tissue and cerebrospinal fluid (Tarnvik, 2007; Hofinger et al, 2009). Considering the MIC breakpoint of 8 mg/L, F. tularensis can be considered susceptible to chloramphenicol, but the clinical use of this antibiotic is currently restricted to meningitis because of potential severe bone marrow toxicity.…”

Section: Antibiotic Susceptibility Testing Of F Tularensismentioning

confidence: 99%

Francisella tularensis Susceptibility to Antibiotics: A Comprehensive Review of the Data Obtained In vitro and in Animal Models

Caspar

Maurin

2017

Front. Cell. Infect. Microbiol.

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The antibiotic classes that are recommended for tularaemia treatment are the aminoglycosides, the fluoroquinolones and the tetracyclines. However, cure rates vary between 60 and 100% depending on the antibiotic used, the time to appropriate antibiotic therapy setup and its duration, and the presence of complications, such as lymph node suppuration. Thus, antibiotic susceptibility testing (AST) of F. tularensis strains remains of primary importance for detection of the emergence of antibiotic resistances to first-line drugs, and to test new therapeutic alternatives. However, the AST methods reported in the literature were poorly standardized between studies and AST data have not been previously evaluated in a comprehensive and comparative way. The aim of the present review was to summarize experimental data on antibiotic susceptibilities of F. tularensis obtained in acellular media, cell models and animal models since the introduction of fluoroquinolones in the treatment of tularaemia in 1989. We compiled MIC data of 33 antibiotics (including aminoglycosides, fluoroquinolones, tetracyclines, macrolides, β-lactams, chloramphenicol, rifampicin, and linezolid) against 900 F. tularensis strains (504 human strains), including 107 subsp. tularensis (type A), 789 subsp. holarctica (type B) and four subsp. mediasiatica strains, using various AST methods. Specific culture media were identified or confirmed as unsuitable for AST of F. tularensis. Overall, MICs were the lowest for ciprofloxacin (≤ 0.002–0.125 mg/L) and levofloxacin, and ranged from ≤ 0.016 to 2 mg/L for gentamicin, and 0.064 to 4 mg/L for doxycycline. No resistant strain to any of these antibiotics was reported. Fluoroquinolones also exhibited a bactericidal activity against intracellular F. tularensis and lower relapse rates in animal models when compared with the bacteriostatic compound doxycycline. As expected, lower MIC values were found for macrolides against type A and biovar I type B strains, compared to biovar II type B strains. The macrolides were more effective against F. tularensis grown in phagocytic cells than in acellular media.

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Section: Antibiotic Susceptibility Testing Of F Tularensismentioning

confidence: 99%

Francisella tularensis Susceptibility to Antibiotics: A Comprehensive Review of the Data Obtained In vitro and in Animal Models

Caspar

Maurin

2017

Front. Cell. Infect. Microbiol.

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“…ABD'de hematojen yayılmaya bağlı pnömoni, ülseroglandüler tularemi olguların %10-15'inde ve tifoidal olguların %30-80'inde gelişirken, primer pnömoni nadiren görülmektedir (10,11). Kuzey Amerika'da ağır seyreden alt tür tularensis infeksiyonunda, septisemi, menenjit, endokardit, perikardit, hepatik yetmezlik, peritonit, akut böbrek yetmezliği ve tromboflebit gibi komplikasyonlar da bildirilmiştir (3,7,10,(12)(13)(14).…”

Section: Tularemi'ye Kısa Bir Bakışunclassified

“…Kloramfenikolün BOS'a geçişinin iyi olması en önemli avantajıdır. Bu nedenle sadece tularemi menenjitinde aminoglikozidlerle (streptomisin) birlikte kullanılması önerilmektedir (13,17). Bu amaçla 25-60 mg/kg/gün dozunda (maksimum 6 gr/gün) iki-dört eşit parçaya bölünerek, İV yoldan 14 gün süreyle (7-21 gün) kullanılmalıdır (4,7,13).…”

Section: Tetrasiklinlerunclassified

Tularemia: A General Overview on Current Treatment Options

Kılıç¹,

Yeşilyurt²

2011

Klimik Dergisi

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ÖzetTularemi, Francisella tularensis'in etken olduğu, dünya çapında bir dağılım gösteren ve farklı klinik belirtilerle seyreden zoonotik bir infeksiyon hastalığıdır. İnsanlarda klinik tablo lokalize hastalıktan fülminan, yaşamı tehdit eden pnömoni veya septisemiye kadar değişmektedir. Tularemi tedavisinde yıllardır streptomisin, gentamisin ve tetrasiklin kullanılmaktadır, ancak son zamanlarda kinolonlar önemli bir alternatif olarak kabul edilmektedir. AbstractTularemia is a zoonotic infection caused by Francisella tularensis with a worldwide distribution and diverse clinical manifestations. In humans, the disease varies from a localized illness to fulminant, life-threatening pneumonia or septicemia. For decades, streptomycin, gentamicin, and tetracycline have been used for the treatment of tularemia, but more recently, quinolones have been considered as acceptable alternatives. However, there are no randomized trials supporting the use of these antibiotics compared with each other. The increasing number of tularemia outbreaks in regions of Turkey outside the classic endemic areas in recent years has prompted renewed interest in this infectious disease. In this review, suggestions about treatment of tularemia are presented in the light of current literature. Klimik Dergisi 2011; 24(1): 2-10.

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“…(with the exception of LVS) is restricted in the US. Resistance to any antibiotic that may be used therapeutically to treat tularemia (Urich and Petersen, 2008; Hofinger et al, 2009) may not be introduced into select agent forms of F. tularensis , which should preclude the introduction of resistance to chloramphenicol, ciprofloxacin, levofloxacin, doxycycline, gentamicin, streptomycin, and tetracycline (Enderlin et al, 1994; Maurin et al, 2000; Antibiotic Selection Guide, 2004). This has restricted the use of antibiotic resistance markers to kanamycin, erythromycin, spectinomycin, rifampin, and hygromycin resistance in these organisms (LoVullo et al, 2006; Qin and Mann, 2006; Buchan et al, 2008; Kalivoda et al, 2010; Klose, unpublished data).…”

Section: Antibiotic Resistancementioning

confidence: 99%

Genetic Manipulation of Francisella Tularensis

Zogaj

Klose

2011

Front. Microbio.

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Francisella tularensis is a facultative intracellular pathogen that causes the disease tularemia. F. tularensis subsp. tularensis causes the most severe disease in humans and has been classified as a Category A select agent and potential bioweapon. There is currently no vaccine approved for human use, making genetic manipulation of this organism critical to unraveling the genetic basis of pathogenesis and developing countermeasures against tularemia. The development of genetic techniques applicable to F. tularensis have lagged behind those routinely used for other bacteria, primarily due to lack of research and the restricted nature of the biocontainment required for studying this pathogen. However, in recent years, genetic techniques, such as transposon mutagenesis and targeted gene disruption, have been developed, that have had a dramatic impact on our understanding of the genetic basis of F. tularensis virulence. In this review, we describe some of the methods developed for genetic manipulation of F. tularensis.

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Tularemic Meningitis in the United States

Cited by 38 publications

References 37 publications

Francisella tularensis Susceptibility to Antibiotics: A Comprehensive Review of the Data Obtained In vitro and in Animal Models

Francisella tularensis Susceptibility to Antibiotics: A Comprehensive Review of the Data Obtained In vitro and in Animal Models

Tularemia: A General Overview on Current Treatment Options

Genetic Manipulation of Francisella Tularensis

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