Who is more at risk?

Poverty and M.tuberculosis are closely linked with each other. The main causative agent for tuberculosis is M.tuberculosis. Tuberculosis is ranks alongside HIV/AIDS as the top notch infectious killer worldwide with 9.6 million of new incident cases and 1.5 million death estimated to have been occurred in 2014[7]. The majority of people who were infected and killed were belong from developing and underdeveloped country. As an airborne disease tuberculosis could affect anyone. People in underdeveloped country have poor access to health and basic hygiene. People often live in crowded , unventilated housing, and polluted places. It got this statistical advantage of being spread rapidly in underdeveloped country were people will have weak immune system. Thus, these people with weak immune system are most susceptible and could get another member in their family/friend boundary to get easily affected.

Various new diagnosis tools are particularly awaited to improve the diagnosis of disease, spreading of diseases, rapid detection of drug-resistance, latent infection, as for use of dosage in the pediatric population and global target. Lowering the burden of this disease and upon complete removal of this epidemic could be the best return in terms of investment. Although the strategy of removing this disease in developed country have tried to be impoverished. But because of the challenge of tuberculosis in global target, mostly in underdeveloped country remains enormous with several challenges which had become problematic to eradicate the disease.Thus, a major concerns must have to be majorly focused if we want Mycobacterium tuberculosis to eliminate in global level.

Refrence

1. Raviglione M, Sulis G. Tuberculosis 2015: Burden, Challenges and Strategy for Control and Elimination. Infectious Disease Reports. 2016;8(2):6570. doi:10.4081/idr.2016.6570.

 

Infection control of Mycobacterium tuberculosis in health care setting

Mycobacterium tuberculosis is transmitted  through airborne particle when person  carrying this bacteria cough or sneeze near the healthy persons. There is high risk of  getting this bacteria transmitted to healthcare worker when they are receiving care. Thus important steps must have to be taken to control this to become widespread epidemics. Especially, Local health agencies who have the greater risk to be targeted anytime. Local health agencies should design a control plan which should include administrative and respiratory protective level of services[1].

Administrative measures:

• Proper education to health care worker, training and counselling healthcare workers and the patient about the Tb infection caused by Mycobacterium tuberculosis.
• Writing and updating a control plan when person have to get exposed with the patient.
• Responsibility should working with the patient should only be given to the designated staff person.

Respiratory Proctection

• A personal protective equipment should be provided when working institution that cause the risk of exposure to TB diseases caused by Mycobacterium tuberculosis
• Educating and training staff on respiratory protection

 

Reference

Pai m, 2007. Protecting health-care workers from tuberculosis in the era of extensively drug-resistant tuberculosis. National Medical Journal of India 20 :1-3.

Testing and Diagnosis of Mycobacterium tuberculosis

Mycobacterium tuberculosis  causes TB, which destroys our body tissue. There are two types of tuberculosis who need attention to be tested. One is Pulmonary TB and Latent TB. Pulmonary tuberculosis(TB) is a contagious bacterial infection that involve lungs and easily spread through organs. It was spread widely as an epidemic during 18th and 19th centuries in North America and Europe. Well now it has been declined due to antibiotics and preventive measure.Once we see the symptoms such as-

• cough up blood
• have night sweats and chest pain
• gradual weight loss and cough almost continuously
• anorexia(variable)
• sputum(usually mucopurulent or purulent

 

then we should go see our doctor to get diagnosed[1]. Once early diagnosis is done, it is curable with antibiotics. Also,We have to make sure that we are using the daily medication.

Whereas, latent TB means person is infected with Mycobacterium tuberculosis but person doesn’t show any symptom or they are not in active phase and the immune system is taking care off. Latent Tb aren’t contagious but there is possibility of almost 10 percent life risk to develop into active or pulmonary TB. It is better to be tested to control the disease.

Diagnosis

The two medical test that helps to diagnosed TB ae blood and skin test. For skin test, Mantoux tuberculin skin test also known as the purified protein derivative test(PPD) is very popular and less expensive test. It as developed in 1908.Usually, Your health specialist injects a small amount of tuberculin which is a complex of purified M.tuberculosis proteins under your skin. It takes 2 to 3 days to detect the reaction formed on the arm. A hard swollen lump of five or more millimeters shows the positive test. This test only determines whether the person has been infected with Mycobacterium tuberculosis or not but fails to explain if they are in active state .

For blood test , your sample will be taken and then expose to tuberculosis in a laboratory. This text results how does your immune system react to bacteria that causes the disease.

Another test known as sputum examination is popular to confirm if the person has active diseases or not followed by mantoux tuberculin skin test. In this test sample of the patient mucus is examined by acid-fast bacilli smear and culture in the laboratory. This will help to provide clear evidence of active Mycobacterium tuberculosis[2].

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Refrence

1. Campbell, I. A., and  Bah-Sow, O., 2006. Pulmonary tuberculosis : diagnosis and treatment . BMJ: British Medical Journal, 332(7551), 1194-1197.
2. Nahid, P., Pai, M., and Hopewell, P. C, 2006. Advances in the diagnosis and treatment of tuberculosis. Proc Amer Thoracic Soc ,(3) 103-110.

Why Mycobacterium innately resistant to Antibiotics?

…….blog #2

β-lactam(are a class of broad-spectrum antibiotics which consist of all antibiotic agents that contain beta-lactam ring in their molecular structures ex-penicillin) antibiotics is among the safest and most widely prescribed antibiotics, but they are not effective in M. tuberculosis due to intrinsic resistance. Most of the resistance is attributed to the cell wall. M. tuberculosis have unusually impermeable cell wall which is advantageous in stressful condition of osmotic shock or desiccation along with antibiotics resistance[1]. Strategies that M. tuberculosis uses in response to the antibiotics includes efflux pump, response regulators, antibiotic-modifying or degrading-enzymes such as β-lactamase, target-modifying enzymes and decoys which mimics the target[2].

…… This paragraph is small introduction to M. tuberculosis resistance which will be continued

 

Reference

1. Hett, E. C., & Rubin, E. J. (2008). Bacterial Growth and Cell Division: a Mycobacterial Perspective. Microbiology and Molecular Biology Reviews : MMBR, 72(1), 126–156. http://doi.org/10.1128/MMBR.00028-07
2. Chambers, H. F., D. Moreau, D. Yajko, C. Miick, C. Wagner, C. Hackbarth, S. Kocagoz, E. Rosenberg, W. K. Hadley, and H. Nikaido. 1995. Can. penicillins and other beta-lactam antibiotics be used to treat tuberculosis? Antimicrob. Agents Chemother. 392620-2624. [PMC free article] [PubMed]

Mycobacterium tuberculosis

  Mycobacterium tuberculosis is the causative agent of tuberculosis, spreads worldwide as one of the most successful obligate bacterial pathogen and is still continues to kill million of people every year. Human acts as the only reservoir of this bacteria. They are highly aerobic bacteria and easily transmitted through coughing , sneezing and speaking around the person who is infected with M.tuberculosis.

Image: M.tuberculosis colonies. Source: CDC/ Dr. George Kubica

 

Epithelial cell are the dominant cell type in the lungs. M.tuberculosis target alveolar macrophage in the lower airways to establish infection[1]. This means that epithelial cell are the first point for the M.tuberculosis to be contacted in the human host. Once the host develop the M.tuberculosis then it is very difficult to view them under compound microscope. Extensive chemical research have shown M.tuberculosis consisting of three component. Out of them the outer layer is composed of mycolic acid which provide mycobacteria with remarkable impermeability to external service. This make it hard to view the with gram staining as they’ll appear both gram positive and gram negative[2].

….To be continued in next week.

 

 

Reference

1. Reuschl, A. et al, 2017. “Innate activation of human primary epithelial cells broadens the host response to M. bacterium in the airways. PLOS Pathogens 13(9).
2. Martinez A, Torello S, Kolter R, 1999. Sliding motility in mycobacteria. Journal of bacteriology 181(23):731-8. [PubMed]