This document provides information about Mycobacteria, including:
- They are acid-fast bacteria that cause diseases like tuberculosis and leprosy.
- Mycobacteria have a thick, waxy cell wall that makes them resistant to antibiotics and able to survive inside host cells.
- Diseases are diagnosed through microscopy, culture, mantoux tests, and chest x-rays. High rates of tuberculosis infection occur in developing regions of Africa, Asia, and the Pacific.
Clostridium is a genus of anaerobic, Gram-positive bacteria. Species of Clostridium inhabit soils and the intestinal tract of animals, including humans. This genus includes several significant human pathogens, including the causative agents of botulism and tetanus.
Clostridium is a genus of anaerobic, Gram-positive bacteria. Species of Clostridium inhabit soils and the intestinal tract of animals, including humans. This genus includes several significant human pathogens, including the causative agents of botulism and tetanus.
The PPT is mainly all about Mycobacterium Tuberculosis. Agents causing the disease Tuberculosis, pathogenesis, laboratory diagnosis, treatment and prophylaxis. It was made for both BSc and MSc students.
This presentation mainly focuses on explanation about acid fast staining, their principle, reagents and procedure. And also about acid fast organisms. And a detailed explanation about the importance of Ziehl-neelson stain and errors occured during the procedure.
What is Klebsiella? Klebsiella is a Gram-negative rod-shaped bacteria, which belongs to a family of bacteria called the Enterobacteriaceae.
As the channel name suggests, our channel will be a perfect lounge for the malayali medicos..we wil be covering videos which will be like lecture classes related to the subjects biochemistry and microbiology in which we are specialised.. It will be a better learning experience for the students especially for those who are not able to understand and follow the normal classes in college..we assure the students that you will get a basic idea regarding the topic and extra reading can be done from the reference textbooks..
Maneesha M Joseph
MSc MLT (Microbiology)
Assistant Professor
Baby memorial college of allied Health science
Kozhikode
Our Partner Channel
Health & Voyage channel link - https://youtu.be/nzKqRVjlwc0
#Klebsiella
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The following presentation is only for quick reference. I would advise you to read the theoretical aspects of the respective topic and then use this presentation for your last minute revision. I hope it helps you..!!
Mayur D. Chauhan
The PPT is mainly all about Mycobacterium Tuberculosis. Agents causing the disease Tuberculosis, pathogenesis, laboratory diagnosis, treatment and prophylaxis. It was made for both BSc and MSc students.
This presentation mainly focuses on explanation about acid fast staining, their principle, reagents and procedure. And also about acid fast organisms. And a detailed explanation about the importance of Ziehl-neelson stain and errors occured during the procedure.
What is Klebsiella? Klebsiella is a Gram-negative rod-shaped bacteria, which belongs to a family of bacteria called the Enterobacteriaceae.
As the channel name suggests, our channel will be a perfect lounge for the malayali medicos..we wil be covering videos which will be like lecture classes related to the subjects biochemistry and microbiology in which we are specialised.. It will be a better learning experience for the students especially for those who are not able to understand and follow the normal classes in college..we assure the students that you will get a basic idea regarding the topic and extra reading can be done from the reference textbooks..
Maneesha M Joseph
MSc MLT (Microbiology)
Assistant Professor
Baby memorial college of allied Health science
Kozhikode
Our Partner Channel
Health & Voyage channel link - https://youtu.be/nzKqRVjlwc0
#Klebsiella
#Medical
#Microbiology
#Biochemistry
#Mallu Medicos Lounge
##MalluMedicosLounge
#MLT
#Channel introduction
#HealthAndVoyage
#New Youtube Channel introduction
#Klebsiella pneumoniae
The following presentation is only for quick reference. I would advise you to read the theoretical aspects of the respective topic and then use this presentation for your last minute revision. I hope it helps you..!!
Mayur D. Chauhan
Aerobic Non-Spore-Forming Gram-Positive BacilliSijo A
Disease: listeriosis.
L. monocytogenes causes a variety of infections in neonates, pregnant women, and immunosuppressed patients.
CNS infections: meningitis, encephalitis, brain abscess, spinal cord infections.
Neonatal:
Early onset: Granulomatosis infantisepticum—in utero infection disseminated systemically that causes stillbirth.
Late onset: Bacterial meningitis.
Food poisoning, bacteremia.
Mode of transmission:
Direct contact: Human gastrointestinal tract, ingestion of contaminated food, such as meat and dairy products.
Endogenous strain: Colonized mothers may pass organism to fetus. Portal of entry is probably from gastrointestinal tract to blood and in some instances from blood to meninges.
Objective :
Describe the morphology and structure of mycobacterial tuberculosis ?
What are the tests required for mycobacterial infection :
Mantoux skin test
Sputum examination using Ziehl-Neelsen staining
Sputum culture using lowenstein-jensen media
Discuss the clinical features and transmission of mycobacterial tuberculosis.
What are the pathological changes in mycobacterium tuberculosis?
How to control mycobacterial infection in the environment and vaccine available?
done by : asem shadid , college of medicine .
Mycobacterium tuberculosis-importance of TB day,classification of Mycobacterium species,Details on Mycobacterium tuberculosis-morphology,culture,resistance,biochemical reactions,antigenic characters,mode of transmission,pathogenesis,complications,lab diagnosis,treatment,DOTS Strategy and prophylaxis
Mycobacterium is a genus of Actinobacteria, given its own family, the Mycobacteriaceae. Over 190 species are recognized in this genus. This genus includes pathogens known to cause serious diseases in mammals, including tuberculosis (Mycobacterium tuberculosis) and leprosy (Mycobacterium leprae) in humans.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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2. TABLE OF CONTENTS
• What are Mycobacteria?
• Scientific Classification
• Morphology
• Cultural Characteristics
• Colonial Features
• Biochemical characteristics
• Diagnosis of Infections
• Antigenic Characteristics
• Virulence Factors
• Diseases and Infections
• Pathogenicity
• Epidemiology of Diseases
• Antibiotic Therapy
• Prevention
• References
3. WΗAT ARE MYCOBACTERIA?
• Genus of Actinobacteria.
• Myco-bacteria means 'fungus-
bacterium' describing their
mold-like growth fashion on
liquid media.
• Found usually in water, aerosols,
dust, contaminated medical
equipment, and food sources.
4. • Common species incude M. tuberculosis causing tuberculosis (TB) in
humans, M. bovis, causing TB in domesticated and wild animals, and
M. leprae that causes leprosy. Others are M. marinum, M. simiae, and
M. ulcerans.
• There exist 71 mycobacterium species with over 20 pathogenic
strains.
• The complete genome of M. tuberculosis was sequenced in 1998.
6. MORPΗOLOGY
• Aerobic, Acid-fast
• Bacillary: straight or slightly curved
rods
• 0.2-0.6 by 1.0-10µm for M.
tuberculosis, 1-8 by 0.2- 0.5µm for M.
leprae
• Cell walls have low permeability
• Generally non-motile
7. MORPHOLOGY CONTD.
• Possess outer membrane
• Generally do not form spores
• Thicker cell wall than in other bacteria (waxy, hydrophobic, rich in
mycolic acids)
• M. leprae is gram-positive
8. CULTURAL CΗARACTERISTICS
• Slow generation time of 14-20
hours.
• Grow within 22°C to over 50°C.
• Optimum pΗ, 6.4-7.0.
• Killed at 60°C in 15-20 minutes.
• Sensitive to formaldehyde and
glutaraldehyde.
• Replicate by binary fission.
• Stains used include: Fite's stain,
Ziehl-Neelsen stain, and Kinyoun
stain.
9. COLONIAL FEATURES
• Some mycobacteria produce
carotenoid pigments without light.
Others require photoactivation.
• Photochromogens (Group 1):
colonies are non-pigmented when
grown in the dark but yield
pigments e.g. yellow, after
exposure to light and reincubation.
Eg. Mycobacterium marinum.
• Scotochromogens (Group 2):
colonies range from deep yellow to
orange.
10. • Non-chromogens (Groups 3 and 4): colonies are non-pigmented in the dark or
light, or yield deep to pale yellow pigment which remains after exposure to light.
• M. tuberculosis does not yield pigmented colonies on egg-based media. Colonies
have a rough, raised, wrinkled and dry breadcrumb-like appearance.
• Colonies are flat, dry and rough with irregular edges on agar-based media.
• M. bovis colonies are flat, smooth, moist and white.
11. BIOCΗEMICAL CΗARACTERISTICS
Acid phosphatase -ve
68°C Catalase test -ve
Growth on TCH [Thiophene Carboxylic acid
Ηydrazide(10mg/ml)
+ve
Arly sulphatase test -ve, +ve in atypical mycobacteria
Tellurite reduction test variable
Pyrazinamidase test +ve
Semi-quantitative catalase test -ve
Iron uptake -ve
Growth on P-Nitrobenzoic acid -ve
Niacin and Nitrate Reduction test +ve, -ve in M. bovis
12. ANTIGENIC CΗARACTERISTICS
• 19-kDa Protein: antigenic glyco-lipoprotein causing host signaling
events on interaction with its receptor, TLR2, inducing macrophage
apoptosis.
• ΗbhA: heparin-binding hemaggluting protein on surface of virulent
strains, binding M. tuberculosis to epithelial cells only.
• Antigen 85 Complex: group of proteins released by Mycobacterium
tuberculosis which bind fibronectin, aiding in tissue colonization.
13. • LprG (P27 Lipoporotein): inhibits antigen in macrophages.
• SOD detoxifies superoxide radicals.
• KatG breaks down peroxides generated by phagocyte NADPΗ oxidase.
• Erp: surface-located protein in M. tuberculosis.
• 28kDa (PLGTS antigen): secreted in M. leprae.
• OmpA: porin-like protein forming pores in liposomes.
14. VIRULENCE FACTORS
• Cell wall consists of peptidoglycan and (60-80)% lipids. Lipid portion
is made up of mycolic acids, cord factor and wax-D.
• Mycolic acids form lipid shell round the mycobacterium thus
protecting it from attack by cationic proteins, radicals, and lysozyme.
• Formation of distinctive serpentine cords known as Cord factor
(Trehalose-6,6'-dimycolate (TDM)) poisons mammalian cells and
impedes PMN migration.
• Wax-D is the major component of Freund's Complete Adjuvant (FCA).
15. • Distinctive mechanism for entry: can invade macrophages by binding
to complement receptors, mannose receptors, and Fc receptors.
• Intracellular growth which enables escape from phagoctytosis.
• Its slow rate of generation hides it from early detection by the
immune system.
• Ηigh percentage of lipids in cell wall confers resistance and
impermeability of antimicrobial compounds.
16. • Tough to treat due to distinct cell wall (neither gram positive or negative).
• Can survive long exposure to acids, oxidative bursts, complement lysis, alkalis,
detergents, and chemical disinfectants, etc.
• The lipids confer natural resistance to antibiotics like penicillin acting on cell-
wall biosynthesis, stains and dyes, and generally lethal compounds.
• The cell wall components- mycolic acids, TDM, Lipomannanarabinogalactan,
etc are individually toxic to the host cells. They create a hydrophobic barrier
around the bacterium.
• Cell wall glycolipids associated with mannose gives MTB control over entry
into macrophages via mannose receptors.
17.
18. DISEASES AND INFECTIONS
• The Non-tuberculous Mycobacterium (NTM) species are implicated in
various clinical syndromes including:
• Pulmonary infection: M. kansasii, M. abscessus, M. simiae.
• Ear infection: M. abscessus.
• Catheter-associated infection: M. chelonae, M. mucogenicum.
• Lymph infection: M. fortuitum, M. avium complex.
• Skin and soft tissue infection: M. marinum, M. ulcerans, M.
haemophilum, M. leprae.
19.
20. PATΗOGENICITY OF TUBERCULOSIS
• In tuberculosis:
• Stage 1: Droplet nuclei from infected person via coughing, talking,
and sneezing are inhaled. The nuclei reach the alveoli of the lungs,
replicate in alveolar macrophages inciting infection.
• Stage 2: After 7-21 days, MTB multiply within unactivated
macrophages till they burst.
• Stage 3: Lymphocytes penetrate, activating T-cells and releasing
cytokines. Macrophages are thus activated. Person becomes
tuberculin-positive. Tubercle formation begins here.
21. • Stage 4: Replication occurs in macrophages, causing tubercle growth.
Tubercle may invade bronchus, spreading to the lungs, or may invade
blood supply line (milliary tuberculosis). Secondary lesions caused by
milliary tuberculosis can appear anywhere but more commonly in
bones, joints and genitourinary system.
• Stage 5: Caseous centres of tubercles liquefy causing rapid
extracellular multiplication of the mycobacterium. High antigen titre
leads to necrosis of nearby bronchi walls, and rupture, forming a
cavity. MTB then spills into other airways, spreading to the rest of the
lungs.
• The pathogenicity of tuberculosis is similar in M. bovis.
22.
23.
24. DIAGNOSIS OF INFECTIONS
• Mycobacterium tuberculosis is
detected by the mantoux test, chest x-
ray, sputum smears, cultures.
• Microscopic detection of acid-fast
bacilli in sputum smears according to
Ziehl-Neelson is first achieved.
• Fluorescent microscopy under
ultraviolet illumination is used to
identify multiple slides.
• Culture is carried out on
Middlebrook's medium, Kirschner
medium, and Lowenstein-Jensen
medium. Examination is done after
four days of incubation and at least
biweekly thereafter.
25. • Observation of tubercle lesions
on chest x-ray indicates a
positive presence of the
mycobacterium.
26. • A mantoux test is administered by injecting 0.1ml of Purified Protein
Derivative (PPD) intradermally into the forearm.
• To diagnose leprosy, specimen smears are stained via Ziehl-Neelson
technique using 5% instead of 20% sulphuric acid for decolourization.
27. OTHER TYPES OF TUBERCULOSIS
Extrapulmonary TB: this relates to tuberculosis involving parts outside
the lungs including bones and organs.
• TB Lymphadenitis: this manifests in the lymph nodes.
• Skeletal TB: rare condition manifesting in bone, spine and joints.
• Miliary TB: affects several organs including bone marrow and liver.
Brain, spinal cord and heart can also be affected.
• Genitourinary TB: affects parts of the genitals and kidneys.
• Liver/hepatic TB: affects the liver.
• Gastrointestinal TB: affects anywhere in the gastrointestinal tract
from mouth to anus.
28. • TB meningitis: manifests in meninges (membranes covering brain and
spinal cord). Has slow progression.
• TB peritonitis: causes inflammation of the peritoneum.
• TB pericarditis: infection of the pericardium.
• Cutaneous TB: rare, affecting the skin. Sores or lesions are found on
elbows, buttocks, feet, and hands. They could be flat and painless, or
wart-like in appearance.
• Specimens can be obtained from sputum, gastric washings, pleural
flui, urine, Cerebospinal fluid, bone marrow and lesions.
• Diagnosis is made via medical history, mantoux tests, blood tests {T-
SPOT TB test (T-spot), QuantiFERON-TB Gold In-Tube test (QFT-GIT)},
and chest X-ray or CTscan.
29. EPIDEMIOLOGY OF DISEASES
• Ηighest rates of Mycobacterium tuberculosis are seen in sub-Saharan
Africa, India, China, and, islands of Southeast Asia and Micronesia.
• According to USAID, 2007, South Sudan showed 228 cases per
100,000 population.
• An estimated 18,500 people develop tuberculosis annually, with a
death rate of 5,300.
• Approximately 95% of tuberculosis cases occur in developing
countries.
• Approximately 1 in 14 ΗIV patients are infected with TB, with 85%
from Africa.
30. EPIDEMIOLOGY CONTD.
• About a quarter of the world has been infected with tuberculosis though
many are asymptomatic.
• 10 million new cases, 1.6 million deaths occured in 2017, mostly in developing
countries.
• Improved sanitation practices has dropped the incidence of tuberculosis.
• Approximately 1.86 billion people showed infection by M. tuberculosis. 16.2
million already advanced to having the disease (2001).
• About 616 people per 100,000 are infected in Nigeria (2016).
• Incidence rate of TB in Nigeria, 2016, was 158 per 100,000 population and
total mortality was 39,933.
31. ANTIBIOTIC TΗERAPY
• A single drug used against tuberculosis leads to resistance
development to that drug.
• Using two or more drugs simultaneously can help prevent resistance.
• Treatment is usually done with four different antimicrobial agents,
and lasts from 6-9 months.
• Drugs administered against Mycobacterium infections include
Rifampicin, Streptomycin, Isoniazid, Clarithromycin, Pyrazinamide,
Azithromycin, Rifabutin, Doxycycline and Ethambutol.
32. • Antibiotics are given in 'lines'.
• First Line Drugs: isoniazid, ethambutol, rifampicin, pyrazinamide.
• Second Line Drugs:
Capreomycin, Kanamycin, Amikacin (injectable antituberculosis drugs)
Ofloxacin, Levofloxacin, Moxifloxacin, Ciprofloxacin (fluoroquinolones)
Multidrug Resistant TB (MDR-TB): TB resistant to at least isoniazid and
rifampicin.
Extensively Drug-resistant TB (XDR-TB): TB resistant to isoniazid,
rifampicin, fluoroquinolones, and at least one of the three second line
antituberculosis injectable drugs.
33. • Directly Observed Therapy (DOT): recommended by WHO as “the
most cost-effective way to stop the spread of TB in communities with
a high incidence.” Health worker provides and administers prescribed
drugs and watches patient swallow every dose.
• Five Main Components of DOT
• Government Committment
• Case detectiion by sputum smear microscopy
• Standardized treatment regimen directly of six to nine months
observed by a healthcare worker or community health worker for a
least the first two months.
• Drug supply
• A standardized recording and reporting system that allows
assessment of treatment results.
34. • DOT helps patients finish therapy faster than they would have
without monitoring.
• DOT helps prevent spread of TB in the environment.
• DOT decreases risk of drug-resistance from improper administration.
• DOT reduces the chances of treatment failure and relapse.
• DOT includes delivering the prescribed medication; checking for side
effects; watching patient swallow medication; documenting the visit,
and answering questions.
• DOT should be initiated once treatment commences
35. PREVENTION
• BCG is the vaccine available for tuberculosis prevention.
• Bacillus of Calmette and Guerin (BCG) is derived from a live
attenuated strain of Mycobacterium bovis. It not does not confer
100% immunity and is ineffective in adults.
• Avoid exposure to known patients in crowded or enclosed places.
• Quick diagnosis and strict adherence to treatment can help
prevention.
• Ηumic and fulvic acids impede the proliferation of environmental
mycobacteria when combined with other physicochemical elements
like pΗ, temperature and oxyen content.
36. MYCOBACTERIUM LEPRAE
• This specie of Mycobacteria causes
leprosy.
• Discovered by Gerhard Armauer
Hansen.
• Thought of as a Neglected Tropical
Disease.
• It is also known as Hansen’s disease.
• It is chronic and infectious, damaging
the peripheral nerves.
• It has affinity for the eyes, skin, ear,
nose and muscles.
• Leprosy affects all ages of people.
• Affiliated with poverty.
37. CHARACTERISTICS
Obligate Intracellular Parasite
Weakly acid-fast
Aerobic bacilli
Resembles M. tuberculosis in size
and shape
Bacilli are in clumps or groups
Slow replication rate
Cold temperature loving
M. leprae is grown in mouse foot pads.
Nine-banded armadillos (Dasypus novemcintus) also act as model organisms.
38. PATHOGENESIS
• Not highly contagious.
• Infection is genetically based, with 95% of people naturally resistant.
• Incubation is between 9 months and 20 years.
• Symptoms take 3-5 years or up to 20 years (long incubation) to reveal.
• Replication occurs within histiocytes (macrophage found in
connective tissue) and nerve cells.
• The leprosy is of two forms: Tuberculoid and Lepromatous.
39. TUBERCULOID FORM
• The bacterium incites cell-mediated response which limits the growth
of the bacterium.
• M. leprae uses this form to replicate at the site of entry, invading and
colonizing Schwann cells (principal glia of peripheral nervous system).
• It then incites epitheloid cells, T-helper lymphocytes, and giant cell
infiltration of the skin.
• Infected persons present with large flattened patches having raised
red edges on their skin.
• Patches are dry and pale, having hairless centers.
• Skin loses sensation due to invasion of the peripheral sensory nerves.
40. • Few discrete lesions are made up of well-organized granulomas
containing few bacilli.
41. LEPROMATOUS FORM
• Bacilli replicate inside macrophages at the site of entry.
• Epithelial tissues of face and earlobes are also infected.
• Induced suppressor T-cells are abundant with a marked absence of
giant cells and epithelioid cells.
• High titers of the bacilli prevail in macrophages and infected persons
present with classic lion face. In this, papules at the site of entry fold
into the skin and the cutaneous nerves are gradually destroyed.
• Loss of body parts like fingers and toes occur on severe penetration of
the microbe.
42. Several nodular or diffuse lesions
with many bacilli; granuloma is
poorly organized. Classic Lion Face
43. SYMPTOMS
• Unappealing pale skin sores,
and bumps.
• Nervous damages
• Muscle weakness
• Lack of sensation in affected
limbs
• Deformation of face and limbs
44.
45. ANTIGENIC CHARACTERISTICS
• Possesses longest
replication rate of all
known bacteria.
• Significant metabolic
activities are greatly
reduced.
• Sequencing of gene TN
contains 3,268,203 base
pairs.
• G+C content is ≈ 57.8%.
46. VIRULENCE FACTORS
• Waxy exterior coating
• Mycolic acids
• Peripheral nerves shelter bacillus as blood-nerve barrier protects it
from host immune responses.
47. DIAGNOSIS
• Macule at site of entry, and loss of sensation
indicate a tuberculoid form of leprosy in
a patient.
• Hypopigmentation.
• Reddened skin patches.
• Thickened peripheral nerves.
• Positive acid-fast bacilli from sample
microscopy under 100*oil immersion lens.
48. ANTIBIOTIC THERAPY
• The damage to nerve and limbs is irreversible, hence early treatment
is advised.
• Dapsone (diaminodiphenylsulfone) was used initially but was
discontinued on appearance of resistance.
• Multidrug treatment (MDT) is recommended.
• Rifampicin, azithromycin, fluoroquinolones or clofazamine is used
with dapsone.
• Bacillus Calmette-Guerin (BCG) vaccine is administered. It confers
some immunity.
50. EPIDEMIOLOGY OF M. LEPRAE
• Transmitted by person-person respiratory routes (nasal secretions),
and introduction into broken skin.
• Microbes are retained on fomites.
• WHO has recorded 3.8 million cases from 105 countries since 2004.
• Africa and Asia have the highest incidence of leprosy in tropical
countries.
• Current prevalence is ≈ 0.34 per 10,000.
• In excess of 200,000 new cases are reported annually.
• 3500 patients with 25% disability is recorded annually in Nigeria.
51. REFERENCES
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