Abstract

The highly infectious and zoonotic pathogen Francisella tularensis is the etiologic agent of tularemia, a potentially fatal disease if untreated. Despite the high average nucleotide identity, which is >99.2% for the virulent subspecies and >98% for all four subspecies, including the opportunistic microbe Francisella tularensis subsp. novicida, there are considerable differences in genetic organization. These chromosomal disparities contribute to the substantial differences in virulence observed between the various F. tularensis subspecies and subtypes. The methods currently available to genotype F. tularensis cannot conclusively identify the associated subpopulation without using time-consuming testing or complex scoring matrices. To address this need, we developed both single and multiplex quantitative real-time PCR (qPCR) assays that can accurately detect and identify the hypervirulent F. tularensis subsp. tularensis subtype A.I, the virulent F. tularensis subsp. tularensis subtype A.II, F. tularensis subsp. holarctica (also referred to as type B), and F. tularensis subsp. mediasiatica, as well as opportunistic F. tularensis subsp. novicida from each other and near neighbors, such as Francisella philomiragia, Francisella persica, and Francisella-like endosymbionts found in ticks. These fluorescence-based singleplex and non-matrix scoring multiplex qPCR assays utilize a hydrolysis probe, providing sensitive and specific F. tularensis subspecies and subtype identification in a rapid manner. Furthermore, sequencing of the amplified F. tularensis targets provides clade confirmation and informative strain-specific details. Application of these qPCR- and sequencing-based detection assays will provide an improved capability for molecular typing and clinical diagnostics, as well as facilitate the accurate identification and differentiation of F. tularensis subpopulations during epidemiological investigations of tularemia source outbreaks.

Highlights

  • The highly infectious and zoonotic pathogen Francisella tularensis is the etiologic agent of tularemia, a potentially fatal disease if untreated

  • F. tularensis subtype A.I, type B, and F. tularensis subsp. novicida strains are distributed throughout the United States, with type B and F. tularensis subsp. novicida strains being endemic throughout the Northern Hemisphere and Eurasia [6, 7]

  • F. tularensis subtype A.II strains appear to be geographically associated with the western regions of the United States, and F. tularensis subsp. mediasiatica strains have been isolated from Central Asian Republics in the former Union of Soviet Socialist Republics (USSR) [8, 9]

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Summary

Introduction

The highly infectious and zoonotic pathogen Francisella tularensis is the etiologic agent of tularemia, a potentially fatal disease if untreated. Novicida from each other and near neighbors, such as Francisella philomiragia, Francisella persica, and Francisellalike endosymbionts found in ticks These fluorescence-based singleplex and nonmatrix scoring multiplex qPCR assays utilize a hydrolysis probe, providing sensitive and specific F. tularensis subspecies and subtype identification in a rapid manner. Sequencing of the amplified F. tularensis targets provides clade confirmation and informative strain-specific details Application of these qPCRand sequencing-based detection assays will provide an improved capability for molecular typing and clinical diagnostics, as well as facilitate the accurate identification and differentiation of F. tularensis subpopulations during epidemiological investigations of tularemia source outbreaks. Novicida contains a single FPI and just a few IS elements but still causes indeterminate identification results with some diagnostic platforms due to a high average nucleotide identity with the select agent strains. Fatality rates as high as 35% from a subtype A.I infection have been reported [6]

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