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Tuberculosis: Mycobacterium Tuberculosis: 1. What Is M.tuberculosis?

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The document discusses Mycobacterium tuberculosis, the bacteria that causes tuberculosis (TB). It covers what M. tuberculosis is, how TB spreads through airborne contact, sites of TB disease like the lungs and lymph nodes, differences between latent TB infection and active TB disease, diagnosis methods like the Mantoux test, and treatment which requires multiple antibiotics over several months.

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Tuberculosis: Mycobacterium Tuberculosis: 1. What Is M.tuberculosis?

Uploaded by

Quan Thieu
33 views3 pages
The document discusses Mycobacterium tuberculosis, the bacteria that causes tuberculosis (TB). It covers what M. tuberculosis is, how TB spreads through airborne contact, sites of TB disease like the lungs and lymph nodes, differences between latent TB infection and active TB disease, diagnosis methods like the Mantoux test, and treatment which requires multiple antibiotics over several months.

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Tuberculosis (1)

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Tuberculosis (1)

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The document discusses Mycobacterium tuberculosis, the bacteria that causes tuberculosis (TB). It covers what M. tuberculosis is, how TB spreads through airborne contact, sites of TB disease like the lungs and lymph nodes, differences between latent TB infection and active TB disease, diagnosis methods like the Mantoux test, and treatment which requires multiple antibiotics over several months.

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33 views3 pages

Tuberculosis: Mycobacterium Tuberculosis: 1. What Is M.tuberculosis?

Uploaded by

Quan Thieu
The document discusses Mycobacterium tuberculosis, the bacteria that causes tuberculosis (TB). It covers what M. tuberculosis is, how TB spreads through airborne contact, sites of TB disease like the lungs and lymph nodes, differences between latent TB infection and active TB disease, diagnosis methods like the Mantoux test, and treatment which requires multiple antibiotics over several months.

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Tuberculosis: Mycobacterium tuberculosis

1. What is M.tuberculosis?
Mycobacterium tuberculosis is an obligate pathogenic bacterial species in the
family Mycobacteriaceae and the causative agent of tuberculosis.
M. tuberculosis has an unusual, waxy coating on its cell surface primarily due to the
presence of mycolic acid
M. tuberculosis can appear either Gram-negative or Gram-positive.
Acid-fast rods, Grow slowly
2. History of TB?
May have evolved from M bovis; acquired by humans from domesticated animals
~15,000 years ago
Endemic in humans when stable networks of 200-440 people established (villages) ~
10,000 years ago; Epidemic in Europe after 1600 (cities)
354-322 BC - Aristotle When one comes near consumptives one does contract their
disease The reason is that the breath is bad and heavyIn approaching the consumptive,
one breathes this pernicious air. One takes the disease because in this air there is something
disease producing.
3. How to the TB transmission?
Airborne Contact; Prolonged Exposure; Occasionally via skin contact or wounds
Not all patient who effected by TB got disease, just about 10-30%

(Airborne contact)
4. What are sites of TB disease?
Pulmonary TB occurs in the lungs 85% of all TB cases are pulmonary
Extrapulmonary TB occurs in places other than the lungs, including the: Larynx
Lymph nodes Brain and spine Kidneys Bones and joints
Miliary TB occurs when tubercle bacilli enter the bloodstream and are carried to
all parts of the body
5. Compare between of Latent TB Infection (LTBI) and TB Disease?
Latent TB Infection (LTBI) TB Disease
Tubercle bacilli in the body
TST or QFT-Gold result usually positive
Occurs when person breathes in bacteria Occurs when immune system cannot keep
and it reaches the air sacs (alveoli) of lung bacilli contained
Immune system keeps bacilli contained Bacilli begin to multiply rapidly
and under control
Person is not infectious and has no Person develops TB symptoms
symptoms
Chest x-ray usually normal Chest x-ray usually abnormal
Sputum smears and cultures negative Symptoms smears and cultures positive
No symptoms Symptoms such as cough, fever, weight,
loss
Not infectious Often infectious before treatment
Not a case of TB A case of TB

6. Diagnosis of TB?
Clinical features are not confirmatory.
Zeil Nielson Stain
Adenosine deaminase test
Culture most sensitive and specific test.
Conventional Lowenstein Jensen media 3-6 wks.
Automated techniques within 9-16 days
PCR is available, but should only be performed by experienced laboratories
Mantoux test
7. Mantoux Test
Infection with Mycobacterium tuberculosis leads delayed hypersensitivity reaction
which can be detected by Mantoux test or PPD Tuberculin Testing.
About 2 to 4 weeks after infection, intracutaneous injection of purified protein
derivative (PPD) of M. tuberculosis induces a visible and palpable induration that peaks in
48 to 72 hours.
Sub cutaneous, Weal formation, Itching no scratch.
Read after 72 hours.
Induration size: 5-10-15mm
8. How to treat TB? (TB treatment)
Most TB is curable, but
Four or more drugs required for the simplest regimen.
6-9 or more months oftreatment required
Person must be isolated until non-infectious
Directly observed therapy toassure adherence/completion recommended
Side effects and toxicity are common -> prolong treatment and infectiousness.
Other medical and psychosocial conditions
complicate therapy
TB may be more severe
Common Drug-drug interactions
Specific Cases:
Latent TB Infection: prevent future active disease.
Daily Isoniazid therapy for 9 months
- Monitor patients for signs and symptoms of hepatitis and peripheral neuropathy
Alternate regimen Rifampin for 4 months
TB disease: treat to cure, prevent transmission
Include four 1st-line drugs in initial regimen: Isoniazid (INH); Rifampin (RIF); Pyrazinamide
(PZA); Ethambutol (EMB).
Adjust regimen when drug susceptibility results become available or if patient has difficulty with
any of the medications; Never add a single drug to a failing regimen
9. The Effects of Immune Suppression from HIV on TB?
Increased risk of reactivation of LTBI (10% annual risk among HIV+ vs. 10%
lifetime risk among HIV-negative individuals)
More likely to have early progression to TB disease following infection
TB can occur at any point in the progression of HIV infection (any CD4 count)
High risk of recurrent TB (either relapse or re-infection)
TB increases HIV replication by activating the immune system
Co-infected persons often have very high HIV viral loads
Immuno-suppression progresses more quickly, and survival may be shorter
despite successful treatment of TB
Co-infected patients have a shorter survival period than persons with HIV who
never had TB disease
10. HIV Status and TB
Determining and recording HIV status for TB cases is critical for:
Making treatment decisions
Monitoring trends
Assessing program performance

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