Mycobacterium tuberculosis: Difference between revisions

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Revision as of 14:36, 4 September 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soumya Sachdeva; João André Alves Silva, M.D. [2]

Overview

Mycobacterium tuberculosis is the bacterium that causes most cases of tuberculosis.^[1] It was first described on March 24, 1882 by Robert Koch, who subsequently received the Nobel Prize in physiology or medicine for this discovery in 1905; the bacterium is also known as Koch's bacillus. The M. tuberculosis genome was sequenced in 1998.^[2]^[3]

Taxonomy

Cellular organisms; Bacteria; Actinobacteria; Actinobacteria; Actinobacteridae; Actinomycetales; Corynebacterineae; Mycobacteriaceae; Mycobacterium; Mycobacterium tuberculosis complex; M. tuberculosis^[4]

Biology

Mycobacterium tuberculosis belongs to the Mycobacterium tuberculosis complex. This complex includes M. tuberculosis, M. bovis, M. africanum, M. canetti, and M. microti.^[5]

M. tuberculosis is an obligate aerobe ( weakly Gram-positive mycobacterium, hence Z.N. staining is used). While mycobacteria do not seem to fit the Gram-positive category from an empirical standpoint (i.e. they do not retain the crystal violet stain), they are classified as an acid-fast Gram positive bacterium due to their lack of an outer cell membrane.^[1] M. tuberculosis divides every 15 to 20 hours—extremely slowly compared to other bacteria, which tend to have division times measured in minutes (for example, E. coli can divide roughly every 20 minutes). It is a small, rod-like bacillus that can withstand weak disinfectants and can survive in a dry state for weeks.

Structure

Slender, straight or slightly curved bacillus with rounded ends, occuring singly, in pairs or in small clumps. These bacilli are acid fast, non sporing, non capsulated and non motile.

Natural Reservoir

Human beings are the main natural reservoir for M. tuberculosis, however, the bacteria may infect other species.^[5]

Resistance

Mycobacteria are killed at 60 degree celsius in 15-20 minutes. They are sensitive to UV rays and sunlight. They are relatively resistant to 5% phenol, 15% sulphuric acid, 5% oxalic acid, 4% sodium hydroxide. The bacillus are destroyed by tincture of sodium in five minutes and by 80% ethanol in 2-10 minutes.

References

↑ ^1.0 ^1.1 Ryan KJ; Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. ISBN 0-8385-8529-9.
↑ Cole ST; Brosch R; Parkhill J; et al. (1998). "Deciphering the biology of Mycobacterium tuberculosis from the complete genome sequence". Nature. 393: 537&ndash, 544.
↑ Camus JC; Pryor MJ; Medigue C; Cole ST. (148). "Re-annotation of the genome sequence of Mycobacterium tuberculosis H37Rv". Microbiology. 2002: 2967&ndash, 2973.
↑ "Poliovirus".
↑ ^5.0 ^5.1 Lawn SD, Zumla AI (2011). "Tuberculosis". Lancet. 378 (9785): 57–72. doi:10.1016/S0140-6736(10)62173-3. PMID 21420161.

[Sherris-1] 1.0 ^1.1 Ryan KJ; Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. ISBN 0-8385-8529-9.

[2] Cole ST; Brosch R; Parkhill J; et al. (1998). "Deciphering the biology of Mycobacterium tuberculosis from the complete genome sequence". Nature. 393: 537&ndash, 544.

[3] Camus JC; Pryor MJ; Medigue C; Cole ST. (148). "Re-annotation of the genome sequence of Mycobacterium tuberculosis H37Rv". Microbiology. 2002: 2967&ndash, 2973.

[NCBI-4] "Poliovirus".

[pmid21420161-5] 5.0 ^5.1 Lawn SD, Zumla AI (2011). "Tuberculosis". Lancet. 378 (9785): 57–72. doi:10.1016/S0140-6736(10)62173-3. PMID 21420161.

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@@ Line 20: / Line 20: @@
 These bacilli are acid fast, non sporing, non capsulated and non motile.
+==Natural Reservoir==
+Human beings are the main [[natural reservoir]] for ''M. tuberculosis'', however, the bacteria may infect other [[species]].<ref name="pmid21420161">{{cite journal| author=Lawn SD, Zumla AI| title=Tuberculosis. | journal=Lancet | year= 2011 | volume= 378 | issue= 9785 | pages= 57-72 | pmid=21420161 | doi=10.1016/S0140-6736(10)62173-3 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21420161  }} </ref>
 ==Resistance==
@@ Line 27: / Line 30: @@
 The bacillus are destroyed by tincture of sodium in five minutes and by 80% ethanol in 2-10 minutes.
-==Diagnosis==
-Sputum is taken in 3 successive mornings as the number of organisms could be low, and the specimen is treated with 3% [[Potassium_hydroxide|KOH]] or [[Sodium_hydroxide|NaOH]] for liquefaction and decontamination. [[Gram stain]] should never be performed as the organism is an "[[acid-fast]] bacillus" (AFB), meaning that it retains certain stains after being treated with acidic solution. In the most common staining technique, the [[Ziehl-Neelsen stain]], AFB are stained a bright red, which stands out clearly against a blue background; therefore, the bacteria are sometimes called ''red snappers''.<ref>{{cite journal |author=Flowers T |title=Quarantining the noncompliant TB patient: catching the "Red Snapper" |journal=Journal of health and hospital law : a publication of the American Academy of Hospital Attorneys of the American Hospital Association |volume=28 |issue=2 |pages=95-105 |year=1995 |pmid=10141473 |doi=}}</ref> The reason for the acid-fast staining is because of its thick waxy cell wall.<ref name=Brock>{{cite book | author = Madigan, Michael; Martinko, John (editors) | title = Brock Biology of Microorganisms | edition = 11th ed. | publisher = Prentice Hall | year = 2005 | id = ISBN 0-13-144329-1 }}</ref> The waxy quality of the cell wall is mainly due to the presence of [[Mycolic acid|mycolic acids]]. This waxy cell wall also is responsible for the typical [[Caseous necrosis|caseous]] [[granuloma]] formation in tuberculosis. The component responsible, trehalose dimycolate, is called the cord factor. A grading system exists for interpretation of the microscopic findings based on the number of organisms obsereved in each field. Acid-fast bacilli can also be visualized by fluorescent microscopy using auramine-rhodamine stain which makes them appear somewhat golden in color. Also, ''M. tuberculosis'' is grown on a selective medium known as Lowenstein-Jensen medium which have traditionally been used for this purpose. However, this method is quite slow; as this organism requires 6-8 months to grow which certainly delays reporting of results. A faster results can now be obtained using Middlebrook medium.
 ==References==