{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:53:12Z","timestamp":1791546792697,"version":"4.3.4"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Tularemia, a zoonotic bacterial infection has re-emerged in many European countries over the last years. Data on the management of tularemia are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The patients showed heterogeneous clinical presentation, including glandular infection (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917, 33.3%), ulceroglandular infection (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923, 45.1%), pulmonary infection (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910, 19.6%) and typhoidal infection (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091, 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 (\u03b2\u2009=\u20090.89,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), as well as the need for a surgical intervention (OR 1.04, 95%CI 1.01\u20131.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Moreover, we demonstrate a high rate of treatment failure in patients receiving monotherapy (27%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-03007-2","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:10:52Z","timestamp":1791544252000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Retrospective two-centre study of human tularemia, Austria"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9181-8614","authenticated-orcid":false,"given":"Lorenz","family":"Schubert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Stanojevic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Krauss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selma","family":"Tobudic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Gattringer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4258-4417","authenticated-orcid":false,"given":"Stefan","family":"Winkler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"3007_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1196\/annals.1409.009","volume":"1105","author":"A Sj\u00f6stedt","year":"2007","unstructured":"Sj\u00f6stedt A. Tularemia: history, epidemiology, pathogen physiology, and clinical manifestations. Ann N Y Acad Sci. 2007;1105:1\u201329. https:\/\/doi.org\/10.1196\/annals.1409.009.","journal-title":"Ann N Y Acad Sci"},{"issue":"12","key":"3007_CR2","doi-asserted-by":"publisher","first-page":"e9106","DOI":"10.2903\/j.efsa.2024.9106","volume":"22","author":"European Food Safety Authority (EFSA), European Centre for Disease Prevention and Control (ECDC)","year":"2024","unstructured":"European Food Safety Authority (EFSA), European Centre for Disease Prevention and Control (ECDC). The European Union One Health 2023 Zoonoses report. EFSA J. 2024;22(12):e9106. https:\/\/doi.org\/10.2903\/j.efsa.2024.9106.","journal-title":"EFSA J"},{"key":"3007_CR3","unstructured":"Bundesministerium f\u00fcr Soziales, Gesundheit, Pflege und Konsumentenschutz. Vorl\u00e4ufiger Jahresbericht meldepflichtiger Krankheiten 2024. (2025). https:\/\/www.sozialministerium.gv.at\/Themen\/Gesundheit\/Uebertragbare-Krankheiten\/Statistiken-und-Fallzahlen.html. Accessed 5 May 2025."},{"issue":"10","key":"3007_CR4","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.3390\/microorganisms8101597","volume":"8","author":"S Seiwald","year":"2020","unstructured":"Seiwald S, Simeon A, Hofer E, Weiss G, Bellmann-Weiler R. Tularemia Goes West: Epidemiology of an Emerging Infection in Austria. Microorganisms. 2020;8(10):1597. https:\/\/doi.org\/10.3390\/microorganisms8101597.","journal-title":"Microorganisms"},{"issue":"4","key":"3007_CR5","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1128\/cmr.15.4.631-646.2002","volume":"15","author":"J Ellis","year":"2002","unstructured":"Ellis J, Oyston PCF, Green M, Titball RW, Tularemia. 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