Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 26, Number 10—October 2020

Seawater-Associated Highly Pathogenic Francisella hispaniensis Infections Causing Multiple Organ Failure

Hua Zhou1, Qing Yang1, Lisha Shen, Yake Yao, Jun Xu, Junhui Ye, Xiaomai Wu, Yunsong Yu, Ziqin Li, Jianying ZhouComments to Author , and Shangxin YangComments to Author 
Author affiliations: The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China (H. Zhou, L. Shen, Y. Yao, J. Xu, J. Zhou); State Key Laboratory for Diagnostic and Treatment of Infectious Diseases, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou (Q. Yang); Sanmen People’s Hosptial, Taizhou, China (J. Ye); Taizhou Hospital, Taizhou (X. Wu); Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, Hangzhou (Y. Yu); Zhejiang-California International Nanosystems Institute, Zhejiang University, Hangzhou (Z. Li, S. Yang); UCLA School of Medicine, Los Angeles, California, USA (S. Yang)

Main Article

Table 2

Drug susceptibility testing results of a Francisella hispaniensis isolate from a 64-year-old fisherman, China

Antimicrobial drug Interpretation* MIC, μg/mL
Amikacin S <2
Colistin R >16
Levofloxacin S ≤0.12
Trimethoprim/sulfamethoxazole R >320
Tobramycin S <1
Piperacillin/tazobactam S <4
Cefoperazone/sulbactam R >64
Ciprofloxacin S <0.25
Imipenem R >16
Minocycline S <1
Ceftazidime R >64
Cefepime S 4
Meropenem R >16
Tigecycline S <0.5
Kanamycin NA 2
Chloramphenicol NA 2
Erythromycin NA 1
Azithromycin NA 0.5
Amoxicillin/clavulanic acid NA >32

*Interpretation was based on the breakpoints for Non-Enterobacteriaceae (5). NA, breakpoint not available; R, resistant; S, susceptible.

Main Article

  1. Maurin  M, Gyuranecz  M. Tularaemia: clinical aspects in Europe. Lancet Infect Dis. 2016;16:11324. DOIPubMedGoogle Scholar
  2. Kreitmann  L, Terriou  L, Launay  D, Caspar  Y, Courcol  R, Maurin  M, et al. Disseminated infection caused by Francisella philomiragia, France, 2014. Emerg Infect Dis. 2015;21:22601. DOIPubMedGoogle Scholar
  3. Huber  B, Escudero  R, Busse  HJ, Seibold  E, Scholz  HC, Anda  P, et al. Description of Francisella hispaniensis sp. nov., isolated from human blood, reclassification of Francisella novicida (Larson et al. 1955) Olsufiev et al. 1959 as Francisella tularensis subsp. novicida comb. nov. and emended description of the genus Francisella. Int J Syst Evol Microbiol. 2010;60:188796. DOIPubMedGoogle Scholar
  4. Aravena-Román  M, Merritt  A, Inglis  TJ. First case of Francisella bacteraemia in Western Australia. New Microbes New Infect. 2015;8:757. DOIPubMedGoogle Scholar
  5. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; twenty-ninth informational supplement (M100-S29). Wayne (PA): The Institute; 2019.
  6. Bina  XR, Wang  C, Miller  MA, Bina  JE. The Bla2 beta-lactamase from the live-vaccine strain of Francisella tularensis encodes a functional protein that is only active against penicillin-class beta-lactam antibiotics. Arch Microbiol. 2006;186:21928. DOIPubMedGoogle Scholar
  7. Antunes  NT, Frase  H, Toth  M, Vakulenko  SB. The class A β-lactamase FTU-1 is native to Francisella tularensis. Antimicrob Agents Chemother. 2012;56:66671. DOIPubMedGoogle Scholar
  8. Ellis  J, Oyston  PC, Green  M, Titball  RW. Tularemia. Clin Microbiol Rev. 2002;15:63146. DOIPubMedGoogle Scholar
  9. Caspar  Y, Maurin  M. Francisella tularensis susceptibility to antibiotics: a comprehensive review of the data obtained in vitro and in animal models. Front Cell Infect Microbiol. 2017;7:122. DOIPubMedGoogle Scholar
  10. Birkbeck  TH, Feist  SW, Verner-Jeffreys  DW. Francisella infections in fish and shellfish. J Fish Dis. 2011;34:17387. DOIPubMedGoogle Scholar
  11. Georgi  E, Schacht  E, Scholz  HC, Splettstoesser  WD. Standardized broth microdilution antimicrobial susceptibility testing of Francisella tularensis subsp. holarctica strains from Europe and rare Francisella species. J Antimicrob Chemother. 2012;67:242933. DOIPubMedGoogle Scholar
  12. Boisset  S, Caspar  Y, Sutera  V, Maurin  M. New therapeutic approaches for treatment of tularaemia: a review. Front Cell Infect Microbiol. 2014;4:40. DOIPubMedGoogle Scholar
  13. Mailman  TL, Schmidt  MH. Francisella philomiragia adenitis and pulmonary nodules in a child with chronic granulomatous disease. Can J Infect Dis Med Microbiol. 2005;16:2458. DOIPubMedGoogle Scholar
  14. Brett  ME, Respicio-Kingry  LB, Yendell  S, Ratard  R, Hand  J, Balsamo  G, et al. Outbreak of Francisella novicida bacteremia among inmates at a louisiana correctional facility. Clin Infect Dis. 2014;59:82633. DOIPubMedGoogle Scholar
  15. Piercy  T, Steward  J, Lever  MS, Brooks  TJ. In vivo efficacy of fluoroquinolones against systemic tularaemia infection in mice. J Antimicrob Chemother. 2005;56:106973. DOIPubMedGoogle Scholar

Main Article

1These authors contributed equally to this article.

Page created: July 13, 2020
Page updated: September 17, 2020
Page reviewed: September 17, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.