Disease- Tuberculosis

Causative Agent- Mycobacterium tuberculosis

Mode Of Transmission- Air

Type Of Organism Affected- Humans

Effect- Tuberculosis generally affects the lungs, but can also affect other parts of the body.
Most infections do not have symptoms, known as latent tuberculosis. About 10% of latent
infections eventually progresses to active disease which, if left untreated, kills about half of
those infected. The classic symptoms of active TB are a chronic cough with blood-tinged
sputum, fever, night sweats, and weight loss.
Description of the microbe
Many cases of tuberculosis are caused by the intracellular pathogen, Mycobacterium
tuberculosis. Mycobacteria are non-motile in slender and beaded rod form containing
peptidoglycan. They exist as obligate aerobics which successfully grow in host tissues
of high oxygen and infect mononuclear phagocytes. Mycobacteria require 12 to 18
hours to grow and divide, and more than 3 weeks to develop colonies which is very slow
compared to other bacteria. All species of mycobacteria are impermeable to Gram stain
because their cell wall is hydrophobic and rich in lipid content lacking outer membrane
causing cells to clump together which make them immune to Gram + staining. Acid-fast
technique is used to stain mycobacteria because their thick waxy cell wall primarily
containing mycolic acid which resists ethanol-based and acidic organic solvents
decolorization. It is an intracellular pathogen that lives in the host and mostly found in
water or soil.
Mycobacterium tuberculosis is highly aerobic which exists in the respiratory system of
high oxygen levels. Possible ways that Mycobacterium tuberculosis causes infection are
through the lungs, invasion of the mucous membranes, and breaking of the skin.
Studies have shown that Mycobacterium tuberculosis attains an unusual
immunopathology and causes either hypoinflammatory or hyperinflammatory response
which reduces its host survival. Hypervirulent Mycobacterium tuberculosis mutants are
determined to have deletions in their cell wall modifying regulators which enable them to
increase the expression of a granuloma that gives a protective layer which maintains its
infection. (3) Mycobacterium tuberculosis’s flexible modular respiratory system enables
it to best utilize the energy production in its captive environments. Sulphur metabolism
is essential to the virulence and intracellular survival of Mycobacterium tuberculosis.
The complex lipid biosynthesis enables Mycobacterium tuberculosis to form thick lipid
cell wall which plays a crucial role in its survival and virulence. Dormancy regulon is a
process by which Mycobacterium tuberculosis exposes to nitric oxide and carbon
monoxide in the absence of aerobic respiration, thus, enabling it to survive in anaerobic
environments.
Transmission of disease
Tuberculosis is caused by a rod-shaped bacterium called Mycobacterium tuberculosis
(Mtb) which primarily enters the body by inhaling Mtb-contaminated air. Symptoms of
Tuberculosis vary depending on the treatment that a person is under and how much the
disease has progressed. Once a person is exposed to the bacteria, the infection is
categorized into three forms: latent Tuberculosis infection, active Tuberculosis, and
multi-drug resistant tuberculosis. A person with latent Tuberculosis has an immune
system that is competent to prevent the spread and keep Mtb to remain in its dormant
form. A person with active tuberculosis is capable of spreading the bacteria to others
and begins to display common symptoms. Mtb begins to grow and infect mainly lungs
and possibly spread to other extrapulmonary parts of the body(6). Active tuberculosis
can be treated by taking antibiotics for several months even though it is more preferable
to get treatment during latent TB infection. Once a person fails to take medications or
get treatments consistently until Tuberculosis is completely cured, it can develop into a
more severe form, known as multi-drug resistant tuberculosis (MDR-TB). MDR-TB
develops as the bacteria becomes resistant to the antibiotics that it has already
encountered, which could ultimately lead to death unless taken alternate medications or
treatment(8).
A person with active pulmonary Tuberculosis can simply release the bacteria into the air
and infect others by exhaling, coughing, spitting, laughing, etc. When Mycobacterium
tuberculosis enters a healthy person, symptoms may not readily appear since the
immune system is strong enough to prevent the bacteria from spreading throughout the
body (bacteria is still alive but not spreading). On the other hand, others are more prone
to active tuberculosis if they:
•are living in contact with someone that has active Tuberculosis
•are nurses or doctors whom are taking care of patients with active Tuberculosis
•have weak immune system from having illness (such as HIV)
•do not have healthcare/ treatment available to cure or prevent the bacteria from
spreading
Once a person has active Tuberculosis, they will display common symptoms such as
sweating/fever, fatigue, consistent coughing for a significant period of time, and difficulty
in breathing(8).
Prevention
Active tuberculosis (TB) is a very contagious infection that is spreads rapidly in a
person's body.To avoid getting an active TB infection:
•do not spend long periods of time in stuffy, enclosed rooms with anyone who has active
TB until that person has been treated for at least 2 weeks.
•use protective measures, such as face masks, if you work in a facility that cares for
people who have untreated TB.
•if you live with someone who has active TB, help and encourage the person to follow
treatment instructions.
To Prevent latent TB from becoming active can be done by treatment with isoniazid for
about 9 months or rifampin for 4 months which can prevent a latent TB infection from
developing into active TB usually. Treatment is recommended for anyone with a skin
test that shows a TB infection, and is especially crucial for people who:
•are known to or are likely to be infected with the human immunodeficiency virus (HIV).
•have close contact with a person who has active TB.
•have a chest X-ray that suggests a TB infection, and have not had a complete course
of treatment.
•inject illegal drugs.
•have a medical condition or take medications that weaken the immune system.
•have had a tuberculin skin test within the past 2 years that did not show a TB infection
but now a new test indicates an infection