Multidrug Resistance of F. tularensis subsp. holarctica, Epizootiological and Epidemiological Analysis of the Situation on Tularemia in the Russian Federation in 2022 and Forecast for 2023

The review provides concise information on the innate ability of cells of the tularemia pathogen, Francisella tularensis subsp. Holarctica, to resist antimicrobials through a variety of mechanisms, leading to its multi-resistance. In total, taking into account new territories, 120 cases of human infection were registered in the Russian Federation in 2022. Epizootic manifestations of the infection of varying degrees of intensity were detected in 58 constituent entities. Against this background, sporadic cases of tularemia in humans were reported in 18 regions of the country. An outbreak of tularemia occurred in the Stavropol Territory; the disease of mild and moderate severity was found in 76 people. The increased incidence of tularemia persists in the Republic of Karelia with severe cases of the disease in the absence of immunoprophylaxis of this infection in the region. A total of 61 cultures of the tularemia pathogen F. tularensis subsp. holarctica, out of which 20 erythromycin-resistant strains were isolated in the Stavropol Territory. In addition, 8 cultures of F. tularensis subsp. mediasiatica from a silt sample and mites Dermacentor silvarum and Haemaphysalis concinna caught in the Republic of Altai were isolated. On the territory of the Russian Federation in 2022, 930 999 people were vaccinated and revaccinated against tularemia. Based on the analysis of the data obtained in 2022, epidemic complications in 2023 in the form of sporadic cases of the disease among the unvaccinated population are most likely to occur in the territories of the Central Federal District – in the Vladimir, Ryazan and Smolensk Regions; Northwestern Federal District – in the Arkhangelsk Region and the Republic of Karelia; Southern Federal District – in the Volgograd and Rostov Regions. The situation in the North Caucasian Federal District will remain tense in the Stavropol Territory; in the Volga Federal District – in the territories of the Saratov Region, as well as in the Kirov Region and the Republic of Mordovia; Ural Federal District – in Khanty-Mansi and Yamalo-Nenets Autonomous Districts; Siberian Federal District – in certain territories of Omsk, Kemerovo, Tomsk, Novosibirsk, Irkutsk Regions, Altai, Krasnoyarsk Territories; in the Far Eastern Federal District, the most intense epizootic activity of natural tularemia foci is in Primorsky Krai.