Mycobacteria
Mycobacteria
Mycobacteria
General characteristics
slender rods ,non motile and do not form spores
are strictly aerobic
Most species grow slowly
lipid-rich cell walls that are resistant to penetration by chemical dyes, such as
those used in the Gram stain
They stain poorly but, once stained, cannot be easily decolorized so they called
acid-fast.
Their cell walls contain unique mycolic acids .
Their cell walls make them impermeable to chemical disinfectants, and resistance
to acids or alkalis.
also resistant to drying, but not to heat or ultraviolet irradiation
Bacteria classified in the genus Mycobacterium on the basis of
Acid- fastness
Presence of mycolic acid
A high G+C
MYCOBACTERIUM TUBERCULOSIS
• Are intracellular pathogens and able to establish lifelong infection
• Slow growing
• Humans are the only reservoir
• Obligate aerobe & non – sporulated
• Withstand week disinfectants and drying
• Acid-fast bacteria due to high concentration of lipids/mycolic fatty
acids in the cell wall
Virulence Mechanisms and Virulence Factors of M.tb
M.tb does not possess the toxins, capsules and fimbriae
However, a number of structural and physiological
properties of the bacterium are contributed to bacterial virulence
and the pathology tuberculosis
Cell wall of M.tb is thick consisting of plasma membrane surrounded by a complex wall
structure harboring virulence factors such as:
• Peptidoglycan
• Arabinogalactans
• Mycolic fatty acid (long chain fatty acids)
• Glycolipids
• Lipoarabinomanans (down regulate the oxidative cytotoxic mechanism)
Clinical significance:
Primary tuberculosis occurs in a person who has had no
previous contact with the organism.
• 10% of those with an arrested primary infection develop
clinical tuberculosis at some later time in their lives.
Primary tuberculosis is usually acquired via the respiratory
tract; therefore, the initial lesion occurs in a small bronchiole
or alveolus in the mid lung periphery.
Primary tuberculosis follows one of two courses:
2. Mycobacterial culture
Middle brook 7H10 & 7H11 media
Lowenstein - Jensen egg based media
Middlebrook 7 H9 & 7H12
3. Molecular Techniques
Treatment
First line anti-TB drugs: Isoniazid (INH), Rifampin,
Ethambutol, Pyrazinamide, Streptomycin
N.B: B/n 1 in 106 & 1 in 108 tubercle bacilli are
spontaneous mutants resistant to first line drugs ----
MDRTB
Second line anti-TB drugs: Kanamycine, Capreomycin
Cycloserine, Ethionamide, Ciprofloxacin
Because strains of the organism resistant to a particular agent
emerge during treatment, multiple drug therapy is employed to
delay or prevent emergence.
Drug resistance: Mutants resistant to each of these agents have
been isolated even prior to drug treatment.
Multidrug-resistant M tuberculosis (MDR-TB) (resistant to both
isoniazid and rifampin) is a major and increasing problem in
tuberculosis treatment and control.
Such strains are prevalent in certain geographic areas (hospitals
and prisons).
Prevention & control
Early case detection & treatment
Decreasing of over crowding
Pasteurization of milk --- ↓ M. bovis infection
Health education
Immunization
A vaccine against tuberculosis has been available since early in the twentieth century.
Specimen:
Scrapings from skin/nasal mucosa
Biopsy from earlobe
Ziehl Neelson staining technique
Culture
has not been successfully maintained in artificial culture, but can be grown in the footpads of
mice and in the armadillo.
Histology
Molecular techniques
Treatment
Dapsone & rifampin
Suppress the growth of M. leprae