This document discusses Mycobacteria and Mycobacterium tuberculosis. It begins by introducing Mycobacteria as acid-fast, aerobic rods. It then discusses the history of discovering M. leprae and M. tuberculosis. Several classifications of Mycobacteria are provided, including M. tuberculosis complex, M. leprae, and non-tuberculous mycobacteria. Extensive details are given on the morphology, pathogenesis, clinical manifestations, diagnosis and treatment of pulmonary and extrapulmonary tuberculosis. Latent tuberculosis and drug-resistant tuberculosis are also summarized.
This presentation is about lab diagnosis of tuberculosis. It highlights use of currently available diagnostic methods in identifying pulmonary and extrapulmonary tuberculosis.
This presentation includes introduction, properties, transmission, epidemiology, pathogenesis, mechanism of infection, immunity and hypersensitivity, clinical manifestations, diagnosis, treatment, prevention and control of MYCOBACTERIUM TUBERCULOSIS.
Dermatophytes , morphology, lifecycle and lab diagnosisSHIPRA SHRIVASTAVA
Dermatophytes are fungi that require keratin for growth. These fungi can cause superficial infections of the skin, hair, and nails. Dermatophytes are spread by direct contact from other people (anthropophilic organisms), animals (zoophilic organisms), and soil (geophilic organisms), as well as indirectly from fomites.
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
This presentation is about lab diagnosis of tuberculosis. It highlights use of currently available diagnostic methods in identifying pulmonary and extrapulmonary tuberculosis.
This presentation includes introduction, properties, transmission, epidemiology, pathogenesis, mechanism of infection, immunity and hypersensitivity, clinical manifestations, diagnosis, treatment, prevention and control of MYCOBACTERIUM TUBERCULOSIS.
Dermatophytes , morphology, lifecycle and lab diagnosisSHIPRA SHRIVASTAVA
Dermatophytes are fungi that require keratin for growth. These fungi can cause superficial infections of the skin, hair, and nails. Dermatophytes are spread by direct contact from other people (anthropophilic organisms), animals (zoophilic organisms), and soil (geophilic organisms), as well as indirectly from fomites.
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
Brief idea- tuberculosis, causative agent, epidemiology of disease in world and India, burden in HIV patients, Burden on Indian Economy, disease symptoms, control programmes implemented by government
Explore the intricate world of Tuberculosis with this comprehensive PowerPoint presentation. Uncover its origins, transmission, symptoms, diagnosis, treatment, and preventive measures. Engage your audience with informative visuals and charts, shedding light on the global impact of TB. Equip your audience with knowledge to raise awareness and foster a proactive approach towards combating this infectious disease.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
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.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
NVBDCP.pptx Nation vector borne disease control program
Mycobacterium
1. Dr. Sumesh Kumar Dash
Department of Microbiology,
IMS & SUM HOSPITAL
MYCOBACTERIA
2. INTRODUCTION
• Mycobacteria are slender rods, weakly
gram positive, obligatory aerobic,
nonmotile, non-capsulated, non-sporing,
usually having slow growth.
• They sometimes show branching,
filamentous forms resembling fungal
mycelium.
• They are acid fast bacilli.
4. CLASIFICATION
• Mycobacterium tuberculosis complex (MTB):-
M.tuberculosis - MCC of TB in human
M.bovis – Bovine tubercular bacilli
Other – Less common pathogen.
e.g: M. africanum, M. microti, M. canetti,
M. caprae,M. pinnipeddi .
• Mycobacterium leprae
• Non-tubercular mycobacteria (NTM):- Mostly saprophytic
in nature or may be found commensal of human or animal.
Very few like M.kansasii, M.fortuitum, M.chelonae can cause
human infection.
6. MORPHOLOGY
• M. tuberculosis is a straight or slightly curved rod
whereas M.bovis is straight and short.
• 3 x 0.3 μm in size.
• They can occur singly, in pairs or as small
clumps.
• They are gram positive, filamentous, club shaped
and branching.
• They are acid fast: Resist decolorization by dilute
acid due to high concentration of Mycolic acid
present in cell wall.
7. PATHOGENESIS
Source of infection
1. Human: Pulmonary TB
2. Bovine source: Consumption of unpasteurized
infected milk
Mode of transition
1. Inhalation: Droplet infection
2. Inoculation: Direct contact
3. Ingestion: Swallowing of sputum, Infected milk
9. Pulmonary Tuberculosis (PTB)
• PTB accounts for 80% of all cases of TB.
FEATURES PRIMARY TB SECONDARY TB
RESULT Initial exogeneous infection with
bacilli
• Exogeneous reinfection
• Reactivation of latent
reinfection
AGE Children Adult
Affected part Lower lobe Upper lobe
Lesion Fibrotic
(Ghon focus)
Calcified
(Simon’s focus)
C/F Asymptomatic or Present with
fever, productive cough, chest
pain, wt loss
Lesions under go necrosis
& tissue destruction leading
to cavity formation.
FATE Lesions heal spontaneously Necrotic lesion breaks
leading to bronchogenic or
hematogenous spread.
10. Extrapulmonary Tuberculosis (EPTB)
EPTB results from hematogenous spread of
bacilli to various organ. It is constitute 15 – 20%.
• Tuberculous lymphadenitis
• Pleural Tuberculosis
• Tuberculosis of upper airway
• Genitourinal Tuberculosis
• Skeletal Tuberculosis
• Tuberculosis of CNS
• Gastrointestinal Tuberculosis
• Tuberculous skin lesion
11. HIV Associated Tuberculosis
• TB is most common diseases in HIV infected
patients as they have low CMI.
• TB occur 70-80% of HIV cases.
• EPTB is more common in these patients.
12. LABORATORY DIAGONOSIS
Specimen collection
• In pulmonary TB: Sputum (2 specimens: spot and early morning), gastric
aspirate (in children)
• In EPTB: Specimens vary depending on the site involved.
Direct microscopy by acid-fast staining
• Ziehl-Neelsen (ZN) technique - long slender, beaded, less uniformly
stained red color acid fast bacilli
• Kinyoun's cold acid fast staining (M.leprae)
• Fluorescent (Auramine)staining
it is more sensitive and
smears can be screened more
rapidly than ZN stain.
13. Digestion, Decontamination and Concentration of specimen
• Modified Petroff's method (4% NaOH)
• NALC (N-acetyl-L-cysteine) +2% NaOH
Conventional culture media (6-8 weeks)
• Sold media - Lowenstein Jensen (LJ) medium
( Shows rough tough and buff colored colonies)
• Liquid media - Kirdchner's medium
Middlebrook 7H9 medium
14. Automated culture methods (3-4 week)
• MGIT System: Detects growth and resistance to antitubercular
drugs (ATDs); with a turnaround time of 2-3 weeks
• BacT/ALERT: Detects growth
• Versatek system: Detects growth and resistance to ATDs.
Culture identification
• MPT 64 antigen detection
• Biochemical tests:
• Niacin test.
• Sensitive to paranitrobenzoic acid
• Catalase peroxidase test
• Aryl sulphatase test
16. RNTCP
• Revised National Tuberculosis Control Program of India has given a
guideline for grading of ZN stained sputum smear.
• However, grading is depend on quality of sputum.
NO. OF AFB SEEN OIF TO BE SEEN GRADING RESULT
No AFB in 100 OIF 100 0 Negative
1-9/100 OIF 100 Scanty Positive
10-99/100 OIF 100 1+ Positive
1-10/ OIF 50 2+ Positive
>10/ OIF 20 3+ Positive
17. LATENT TUBERCULOSIS
• Latent TB occurs when a person has the TB bacteria
within their body, but the bacteria are present in very
small numbers.
• They are kept under control by the body's immune
system and do not cause any symptoms.
• Latent TB is diagnosed by demonstration of delayed
type or type IV hypersensitivity reaction against
tubercle bacilli antigen.
18. Traditionally, the tuberculin test has been in use for diagnosis of latent
TB for >100 years. It was discovered by Von Pirquet in 1907.
Antigens used:
PPD (Purified Protein Derivative antigen) It is a purified preparation of
the active tuberculoprotein.
Dosage:
It is expressed in tuberculin unit (TU). One TU is equal 0.00002 mg of
PPD
Procedure:
0.1 mL of PPD containing 1 TU is injected intradermally into flexor
surface of forearm
Tuberculin Test
19. Reading:
It is taken after 48-72 hours. At the site of inoculation, an induration
surrounded by erythema is produced. If the width of the induration is:
• ≥ 10 mm: Positive (tuberculin reactors)
• 6-9 mm: Equivocal/doubtful reaction
• 5 mm: Negative reaction.
Interpretation of result
• Adults: Positive tuberculin test
in adults only indicates present
or past exposure with tubercle
bacilli but does not confirm the
presence of active stage of the
disease.
• Children: In children, positive
test indicates acne infection and
used as diagnostic marker.
20. • False-positive:
» The test becomes positive after BCG vaccination
(after 8-14 weeks)
» Nontuberculous mycobacteria infection.
• False-negative:
» Early or advanced TB,
» Miliary TB
» Decreased immunity (HIV-infected people)
•
21. TREATMENT
• ATDs are classified into 2 groups
First-line drugs (DS-TB)
• Isoniazid (H)
• Rifampicin (R)
• Pyrazinamide (Z)
• Ethambutol (E)
• Streptomycin (S)
Second-line drugs (DR-TB)
• Fluoroquinolones
• Aminoglycosides
• Macrolides
• Ethionamide & Prothionamide etc.
22. AIM OF TREATMENT
o Interrupt transmission by rendering patients non-
infectious.
o Prevent morbidity and death by curing patients.
o Prevent the emergence of drug resistance.
o Prevent relapse.
23. STRATEGIES
• Multidrug therapy: Combination of more than one drug for rapid
and effective killing of tubercle bacilli.
• Short course chemotherapy lasting for 6 months (or longer for DR-TB)
• Two phase chemotherapy: The short course is divided into
• Intensive phase: Aims at aggressive treatment with multiple
ATDs that rapidly kill the bacilli making the smear negative,
followed by:
• Continuation phase: Aims at killing the remaining dormant
bacilli and prevents relapse.
24. DOTS strategy
• Directly Observed Treatment, Short course
• It is recommend by RNTCP and WHO.
• Here, the strategies used are:
o The entire treatment course is supervised to improve the
patient's compliance
o Treatment response is also monitored by sputum smear
microscopy at the end of each phase.
25. REGIMENS
• Standard regimen for DS-TB: 2 Regimen
• Doses: All drugs must be given in fixed dose combination (FDC),
should be taken orally, once a day.
• Regimens for DR-TB: The treatment for DR-TB is complex, consists
of use of higher numbers of second-line agents, given for longer
duration.
CATEGORY DEFINATION INTENSIVE
PHASE
CONTINUTION
PHASE
CATEGORY-I New cases
Received ATDs <1 month
(2)HRZE (4)HRE
CATEGORY-II Previously treated patients
Treatment after failure
Recurrent
Treatment after loss to follow up
(2)HRZES
+
(1)HRZE
(5)HRE
26. FOLLOW-UP OF TREATMENT
Patients should be followed up at scheduled intervals for the
assessment of improvement in clinical and laboratory parameters.
• Clinical follow-up: Should be carried out at least monthly during
treatment
• Laboratory follow-up: For PTB cases, sputum smear examination is
done at the end of intensive phase. Sputum smear plus culture is
done for every patient at the end of treatment.
• Long term follow-up is carried out up to 2 years of completion of
treatment
• Follow-up for MDR TB: Sputum smear and culture are performed
every month during intensive phase and every 3 months during
continuation phase.
27. DRUG RESISTANCE
• Mono resistance: Resistance to only one first-line ATDs.
• Poly resistance: Resistance to >1 first-line ATDs.
• Rifampicin resistance (RR): Resistance to Rifampicin with or without
resistance to other ATDs.
• Multidrug-resistance tuberculosis (MDR-TB): Resistance to both
Isoniazid & Rifampicin with or without resistance to other ATDs.
• Extensively drug-resistance tuberculosis (XDR-TB): These are
MDR-TB (+) Fluoroquinolones (+) one 2nd-line injectable agent(SLI)
• Pre-XDR-TB: MDR-TB (+) Fluoroquinolones (or) SLI
29. Non-tuberculous mycobacteria have been classified into four
groups by Runyon (1959), based on pigment production and
rate of growth.
RUNYON GROUP PROPERTY SPECIES
Photochromogens Produce pigment only
on light
M.kansasii,
M.marinunm
Scotochromogen Produce pigment both
in dark & light
M.scrofulaceunm,
M.gordonae
Non-chromogens Do not produce
pigment
M. Avium-
intracellulare complex
(MAC)
M. xenopi,
M. Ulcerans
Rapid growers Grow with in 1 week M.chelonae,
M.fortuitum
30. CLINICAL MANIFESTRATION OF NTM
DISEASE ORGANISM
Pulmonary
infection
M. Avium-intracellulare complex,
M. xenopi, M.kansasii
Lymph node
infection
M. Avium-intracellulare complex
Cutaneous
infection
M.chelonae, M.fortuitum –
Injection abscess
M.Marinunm – Swimming pool
granuloma
M. Ulcerans – Buruli ulcer
Disseminated
infection
M. Avium-intracellulare complex,
M.kansasii
31. LABORATORY DIAGONOSIS
• Specimen are collected as per infection and lesion.
• Microscopy is done by ZN staining.
• Culture on LJ medium.
• Pigment production.
TREATMENT
• Just as tuberculosis, NTM infection are treated with multi drug
therapy.
• MAC, M.kansasii, M.Marinunm need macrolide, ethambutol and
rifamycin combine.
• Macrolide need to be given prophylactically to the indivisual
infected with HIV.
