Retrospective two-centre study of human tularemia, Austria

PURPOSE: Tularemia, a zoonotic bacterial infection has re-emerged in many European countries over the last years. Data on the management of tularemia are scarce. METHODS: In this two-centre retrospective cohort study, we describe real-world data on the clinical manifestations, diagnostic procedures and management of 51 tularemia patients in East Austria. RESULTS: The patients showed heterogeneous clinical presentation, including glandular infection (n = 17, 33.3%), ulceroglandular infection (n = 23, 45.1%), pulmonary infection (n = 10, 19.6%) and typhoidal infection (n = 1, 2%). Notably, seven cases were culture positive, including one case with positive blood culture. Time to achieve the correct diagnosis was associated with the duration of treatment (β = 0.89, p < 0.001), as well as the need for a surgical intervention (OR 1.04, 95%CI 1.01-1.09, p = 0.04). Moreover, we demonstrate a high rate of treatment failure in patients receiving monotherapy (27%). CONCLUSION: We highlight the heterogeneous clinical presentation of tularemia patients in Austria. Further we demonstrate that timely diagnosis and a prompt implementation of an appropriate antimicrobial therapy may contribute to shorter treatment durations and a reduced need for surgical intervention.