Mycobacterium tuberculosis

Bacteria
 CLASSIFICATION
 Higher order taxa
 Domain: Bacteria;
 Phylum: Actinobacteria;
 Class: Actinobacteria;
 Order: Actinomycetales;
 family: Mycobacteriaceae;
 Genus: Mycobacterium
 CLASSIFICATION

 Species
 The Mycobacterium tuberculosis complex (MTC) consists
of
 Mycobacterium africanum,
 Mycobacterium bovis,
 Mycobacterium canettii,
 Mycobacterium microti,
 Mycobacterium tuberculosis.
 SPECIES
 Mycobacterium tuberculosis- is the etiologic agent of tuberculosis 
in humans. Humans are the only reservoir for the bacterium.
 Mycobacterium bovis is the etiologic agent of TB in cows and rarely in
humans. Both cows and humans can serve as reservoirs. Humans can also
be infected by the consumption of unpasteurized milk. This route of
transmission can lead to the development of extrapulmonary TB,
exemplified in history by bone infections that led to hunched backs .
 Other human pathogens belonging to the Mycobacterium genus include
Mycobacterium avium which causes a TB-like disease especially
prevalent in AIDS patients, and Mycobacterium leprae, the
causative agent of leprosy.
 CHARACTERISTIC
 Mycobacterium tuberculosis is a fairly large nonmotile
rod-shaped bacterium distantly related to the Actinomycetes. Many
non pathogenic mycobacteria are components of the normal flora
of humans, found most often in dry and oily locales. The rods are
2-4 micrometers in length and 0.2-0.5 um in width.
 obligate aerobe.
 The bacterium is a facultative intracellular parasite, usually of
macrophages, and has a slow generation time, 15-20 hours, a
physiological characteristic that may contribute to its virulence.
 is not classified as either Gram-positive  or Gram-negative
 CHARACTERISTIC
 Two media are used to grow MTB
 Middlebrook's medium which is an agar based medium
 Lowenstein-Jensen medium which is an egg based medium. MTB
colonies are small and buff colored when grown on either medium. Both
types of media contain inhibitors to keep contaminants from out-growing
MT. It takes 4-6 weeks to get visual colonies on either type of media.
 due to their impermeability by certain dyes and stains.
 Mycobacterium tuberculosis is the Ziehl-Neelsen stain. When this method
is used, the MTB. smear is fixed, stained with carbol-fuchsin (a pink dye),
and decolorized with acid-alcohol. The smear is counterstained with
methylene-blue or certain other dyes. Acid-fast bacilli appear pink in a
contrasting background.
 CHARACTERISTIC
 The cell wall structure of Mycobacterium tuberculosis deserves special
attention because it is unique among procaryotes, and it is a major
determinant of virulence for the bacterium. The cell wall complex contains
peptidoglycan, but otherwise it is composed of complex lipids. Over 60% of
the mycobacterial cell wall is lipid. The lipid fraction of MTB's cell wall
consists of three major components, mycolic acids, cord factor, and
wax-D.
 Mycolic acids are strong hydrophobic molecules that form a lipid shell
around the organism and affect permeability properties at the cell surface. 
Mycolic Acids are thought to be a significant determinant of virulence in
MTB. Probably, they prevent attack of the mycobacteria by cationic proteins,
lysozyme, and oxygen radicals in the phagocytic granule. They also protect
extracellular mycobacteria from complement deposition in serum.
 CHARACTERISTIC
 Cord Factor is responsible for the serpentine cording mentioned above. Cord
factor is toxic to mammalian cells and is also an inhibitor of PMN migration. Cord
factor is most abundantly produced in virulent strains of MTB.
 Wax-D in the cell envelope is the major component of Freund's complete
adjuvant (CFA).
 The high concentration of lipids in the cell wall of Mycobacterium tuberculosis
have been associated with these properties of the bacterium:
Impermeability to stains and dyes
Resistance to many antibiotics
Resistance to killing by acidic and alkaline compounds
Resistance to osmotic lysis via complement deposition
Resistance to lethal oxidations and survival inside of macrophages
 Morphology
 the structure of Mycobacterium Tuberculosis when viewed
under the microscope shows slender rods (this why they are
called Bacilli rods). This bacterium is difficult to staining but
once stained, it becomes resistant to decolorization by diluted
mineral acids this is the reason why Mycobacterium
tuberculosis is called Acid Fast bacilli (AFB).
 Description
 Mycobacteria are abundant in soil and water, but Mycobacterium tuberculosis is mainly identified
as a pathogen that lives in the host. Some species in its Mycobacterium tuberculosis complex have
adapted their genetic structure specifically to infect human populations.
 M. tuberculosis can be isolated in labs and stored at –80 degrees to be studied extensively, and
the most commonly used strain of M. tuberculosis is the H37Rv strain. One way to study M.
tuberculosis in culture is to collect samples of mononuclear cells in peripheral blood samples from
a healthy human donor and challenge macrophages with the MTC. M. tuberculosis has very simple
growth requirements and is able to grow slowly in harsh conditions. Their acid-fast property is the
strongest when there is glycerol around. However, when glucose is the main source of nutrient,
the utilization of glycerol by M. tuberculosis is inhibited. Therefore, it’s been shown that
glutatmate, and not glucose, is actually the main source of nutrient for initiating growth. (4)
 Since as many as 32% of the human population is affected by Tuberculosis (TB), an airborne
disease caused by infection of M. tuberculosis in one way or another, and about 10% of them
becomes ill per year (6), it is not hard to imagine the significance in understanding the genome of
the pathogen to develop and improve strategies for treatment by developing specific drugs that
target the gene products of M. tuberculosis.
 The Disease
 tuberculosis (TB) is a disease caused by infection from the bacteria M. tuberculosis. If not
treated properly, TB can be fatal (1). Currently, the World Health Organization estimates
that over 13 million people have TB and about 1.5 million die each year from the
disease. Tuberculosis most commonly affects the lungs (pulmonary TB). Patients with
active pulmonary TB usually have a cough, an abnormal chest x-ray, and are infectious.
TB can also occur outside of the lungs (extrapulmonary), most commonly in the central
nervous, lymphatic, or genitourinary systems, or in the bones and joints (1). Tuberculosis
which occurs scattered throughout the body is referred to as miliary TB. Extrapulmonary
TB is more common in immunosuppressed persons and in young children (2).

When a person with active pulmonary TB coughs, sneezes, or talks, the bacteria that
cause TB may spread throughout the air. If another person breathes in these bacteria,
there is a chance that they will become infected with tuberculosis. Repeated contact is
usually required for infection (1). However, not everyone infected with TB bacteria
becomes sick. Roughly 5% of people infected with M. tuberculosis actually develop TB.
People who are infected but not sick have latent TB infection. Those who have a latent
infection are asymptomatic, do not feel sick, and are not contagious.
 Nature of Disease

Exposure to M. tuberculosis may lead to infection, but most infections do not

lead to disease. The risk of developing disease following infection is generally
5–10% during the lifetime but may be increased by various factors, notably
immunosuppression (e.g. advanced HIV infection).

Multidrug resistant tuberculosis (MDR-TB) refers to strains of M. tuberculosis

that are resistant to at least isoniazid and rifampicin. The resistant strains do
not differ from other strains in infectiousness, likelihood of causing disease,
or general clinical effects; if they do cause disease, however, treatment is
more difficult and the risk of death will be higher. Extensively drug-resistant
TB (XDR-TB) is TB that is resistant to at least isoniazid and rifampin, to any
fluoroquinolone and to at least one of the injectable second-line anti- TB
drugs capreomycin, kanamycin and amikacin.
 SYMPTOMS
 1. Coughing that lasts three or more weeks.
 2. Coughing up blood
 3. Chest pain, or pain with breathing or coughing
 4. Unintentional weight loss
 5. Fatigue
 6. Fever
 7. Night sweats
 8. Chills
 9. Loss of appetite
 PREVENTION
 1. Vaccination of BCG (Bacillus
Calmette - Guerin) for infants.
 2. Always use mask when you go to
public place.
 3. Proper hygiene
 TRANSMISSION
 TB is spread through the air from one person to another. Microscopic
droplets that contain the bacteria may be expelled when a person who has
infectious TB coughs or sneezes. They can remain suspended in the air for
several hours, depending on the environment. When a person breathes in
M. tuberculosis, the bacteria can settle in the lungs and begin to grow.
From there, they can move through the blood to other parts of the body. TB
in the lungs can be infectious because the bacteria are easily spread to
other people. TB in other parts of the body, such as the kidney or spine, is
usually not infectious
 . If a person has confirmed TB or is suspected of having TB, the best way to
stop transmission is through immediate isolation. Therapy should begin
immediately. Contagiousness declines rapidly after a standard treatment
regimen has begun, provided the patient adheres to the course of therapy.