Tuberculosis

Mycobacterium tuberculosis was observed by Robertfrom most other mycobacteria by the production of
Koch in 1882, who discovered the staining techniqueniacin.
to see the bacterium.Mycobacterium tuberculosis is a Gram positive aerobic
In 1943, Selman A Waksman found the antibioticmycobacterium that divides every 16-20 hours. This is
effective against Mycobacterium tuberculosis.extremely slow as compared to other bacteria which
Streptomycin purified from streptomyces grieseustend to have division times measured in minutes(for
was administered to human in 1944.example Ecoli can divide roughly every 20 minute.)
Drug resistance in TB occurred as a result of tubercleMycobacterium tuberculosis are grown on lowenstein
bacillus mutations. Soon the resistant mutantsjensen media. Middlebrook media are used for faster
appeared, prooving the antibiotic therapyculture.
unsuccessful. Therefore combination of drugs wereBacteria can takes weeks to grow on culture media.
used to solve the problem of antibiotic resisitance.The Polymerase chain reaction is the rapid method
Multidrug reisistant tuberculosis-- MDR TB is TB that iswhich provides results within hours from specimen of
resisitant to atleast two of the best anti TB drugs,the patients.
isoniazed and rifamycin which are called first lineTB refers only to disease caused by Mycobacterium
drugs.tuberculosis.
Extensively drug resistant TB is defined as TB whichSimilar disease ocassionally result from M.bovis,M
is resistant to isoniazed and rifamycin plus resisitantafricanum, M.microti.
to any fluoroquinolone and atleast one of threeTB of tonsils, lymph node, abdominal organs, bones
injectable second line drugs(amikacin, kanamycin orand joints was once commonly caused by ingestion
capreomycin.of milk infected with M. bovis but such infection is
MDR-TB varies from patients to patients.largely eradicated in developed countries by
Antibiotics such as para-aminosalicyclic acid  andslaughtering cows that test positive.
streptomycin have been in use for more than 50Cell wall of Mycobacterium tuberculosis contains
years.peptidoglycan and complex lipids. 60% of the cell wall
Patients are required to take upto 15 pills a day, plusis lipid. The lipid fraction consisit of mycolic acid, cord
daily injections, for atleast six months.factor and wax D.
Medical treatment is lengthy and protection throughMycolic acid are hydrophobic molecules that affect
vaccination is today, as before is insufficient.permeability properties at cell surface.
Every year nearly two million people die from theMycolic acid prevent attack of the Mycobacteria by
disease. The bacterium that cause TB are spread incationic proteins, lysozyme and oxygen radicals in
airborne droplets when people with disease cough orphagocytic granule.
sneeze.Cord factor is toxic to mammalian cells.
TB is considered lung disease however it can attackLipids cause resistance to many antibiotics and killing
other parts of body such as kidneys or the brain.by acidic and alkaline compounds and resistance to
TB is highly contagious and is spread through air.lethal oxidation and survival inside the macrophages.
Mycobacterium tuberculosis is resisitant toMycolic acid give rigid cell shape to the bacteria.
disinfectants, desiccation and are difficult to stain withThe type of mycolic acid can be used to distinguish
water based stain such as Gram.different Mycobacteria.
Infection with tubercle bacillus is characterised by theMycolic acid isolated from Mycobacteria are called
formation of tubercles, hard nodules in the lungseumycolic acids which have elevated 60-90 carbon
when Mycobacterium tubercle enters the lungs theatoms.
macrophages engulf the pathogen but are unable toMycolic acids are complex hydroxylated branched
digest the bacteria due to it’s waxy mycolic acidchain fatty acids with elevated carbon numbers.
cell wall.They may also contain diverse functional groups such
Mycobacteria begin to multiply within theas methoxy, keto, epoxy ester group and
macrophages, eventually killing the macrophages thatcyclopropane ring.
protect the host.Mycolic acids containing a methoxy group with double
The cycle continues as the bacteria released frombond or cyclopropane ring are known as
dead macrophages are then engulfed by othermethoxymycolic acids.
macrophages.Mycolic acids containing an a methyl-branched ketone
The infected macrophages result in inflammatoryare known as ketomycolic acids and those containing
response(heat, swelling, dilated capillaries)an a-methyl-branch epoxide as epoxymycolic acids.
The cells at the centre of the tubercle mayMycolic acid known as wax esters contain a double
eventually die, producing either an area of necrosis orbond or a cyclopropane ring and an internal ester
an actual cavity.group.
Mycobacterium tuberculosis can be differentiated