Mycobacterium Flashcards
What is the metabolism of M.tuberculosis?
- Aerobic
- Catalase (+)
- Slow growth rate
What is the morphology of M.tuberculosis?
- 40% of total cell dry weight is lipid.
- Composed of mycolic acids.
- Thin rods.
- Non motile.
What is the role of mycosides in the virulence of M.tuberculosis?
- Cord factor
- Sulfatides - inhibit phagosome-lysosome fusion.
- Wax D - acts as an adjuvant
Besides mycosides, what other virulent factors does M.tuberculosis utilize?
- Iron Siderophore - mycobactin.
2. Facultative intracellular growth - Can survive and multiply in macrophages.
Has M.tuberculosis toxins?
Neither exotoxin nor endotoxins. It has lipopolysaccharide, but no lipid A.
What happens in primary TB?
- Asymptomatic
2. Overt disease, involving lungs or other organs.
What happens in secondary TB?
- Pulmonary problems
- Pleural or pericardial lesions
- Lymph node infection
- Kidney
- Skeletal
- Joints
- CNS
- Miliary TB
How do we diagnose M.tuberculosis?
- Acid-fast stain of specimen.
- Rapid culture
- PPD skin test
- IGRA (interferon gamma release assay)
- Chest X ray
- Gene Xpert MTB/RIF (and similar PCR based studies)
What happens in rapid culture of M.tuberculosis?
- Bactec radio metric culture, a liquid broth in a bottle, with radioactive palmitate as a carbon source.
- Mycobacteria grow and use carbon, allowing early detection (1-2 weeks), even before colonies can be seen.
What happens in PPD?
Measure of zone of induration:
>5mm: immunocompromised host.
>10mm: chronic disease or risk factors for exposure to TB.
>15mm: all others.
When do we get false negatives PPD?
In patients with AIDS or malnourished individuals.
What is useful to remember about the virulence of M.tuberculosis?
- Non motile
- No capsule
- No attachment pili
What is the metabolism of M.leprae?
- Catalase (+)
- Grows best at low temperatures
- Phenolase (+) - converts dopa into pigmented product (used for diagnosis).
What is the virulence of M.leprae?
- Non motile
2. Facultative intracellular growth
What happens in lepromatous leprosy?
- Low cell-mediated immunity
- Organisms found everywhere (organs and blood)
- Skin, nerves, eyes and testes involved bilaterally.