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ETIOLOGY OF
TUBERCULOSIS
DR.P.HEMA SUGANYA M.D.
(MICROBIOLOGY)
CONTENT
 HISTORY
 MORPHOLOGY
structure of cell wall
Acid fast bacilli
 CULTURAL CHARACTERISTICS
 RESISTANCE
 ANTIGENIC PROPERTIES
CAUSATIVE ORGANISM
MYCOBACTERIUM TUBERCULOSIS
TUBERCULOSIS- OLDESTDISEASE
Aristotle said 354-322 BC – “When one comesnear
consumptives… one doescontracttheir disease… The
reason is that the breath is bad and heavy…In
approaching the consumptive, one breathes this
pernicious air.One takes the disease because in this
air there is somethingdisease producing.”
ROBERT KOCH- KOCH’S BACILLI
TUBERCULOSIS KILLS NOTONLY POOR BUT RICH
AND FAMOUS
MISSION STARTS……..
8
WHATARE MYCOBACTERIA?
• Fungus like bacteria
• Obligate aerobes grows high oxygen content, such as the
lungs.
• Facultative intracellular pathogens usually infecting
mononuclear phagocytes
– Obligate parasites
– Opportunist pathogens
– Saprophytes
MYCOBACTERIUM TUBERCULOSIS COMPLEX
 M.tuberculosis(human tubercle bacilli)
 M.bovis (bovine tubercle bacilli)
 M.caprae
 M.africanum
 M.microtti
 M.pinnipedii
 M.canetti
MORPHOLOGY OF M.TB
 Slowgrowing,
aerobic,
non motile ,
non sporing,
Noncapsulated
.weakly Gram positive
• Straight, slightly curved
Rod shaped 3 x
0.3microns
• May be single, in
pairs or in small
clumps
CELL WALL OF M.TB
ACID FAST STAINING
13
• Primary stain binds cell wall
mycolic acids
• Intense decolorization does not
release primary stain from the cell
wall of AFB
• Color of AFB-based on
primary stain
• Counterstain provides contrasting
background
ACID FAST BACILLI –ZEIHL NEELSON
STAINSTAINING
1
4
ACID FAST BACILLI SEEN AS IN FLUORESCENT MICROSCOPE
Dr.T.V.Ra
o MD
1
5
MTB : CULTURAL CHARACTERS
• Grow slowly. Generation time 14-15 hrs
• aerobic
• > 2 weeks minimal required period
• Grows at 370c do not grow below 250c or above 400c .
• Phbetween 6.4 to 7.0
16
SOLID MEDIA LIQUID MEDIA
 LOWENSTEIN –JENSEN
MEDIA
 EGG BASED-
PETRAGNINI, DORSET
 BLOOD BASED- TARSHIS
 SERUM BASED –
LOEFFLER
 POTATO BASED-
PAWLOWSKY
 DUBO’S
 MIDDLEBROOKS
 PROSKAUER,
 BECKS,
 SULA
 SAUTONS
Lowenstein Jensen Medium
Selective. Always in screw capped bottle. Bluish Green.
Contains – Egg protein – Solidifying agent
Mineral salts – Mg Sulphate, Mg citrate
Asparagine
Malachite Green – Selective agent
Sterilized by - Inspissation
1
8
ON LIQUID MEDIUM
o
19
• Appearas
long serpentine
cords in liquid
medium
• Avirulent strains grow in a
more dispersed manner.
BIOCHEMICAL TESTS
• NIACIN TEST
• ARYL SULPHATASE TEST
• CATALASE- PEROXIDASE TEST
• NITRATE REDUCTION TEST
• AMIDASE TEST
• PYRAZINAMIDASE TEST
• INHIBITION BY T2H
• NEUTRAL RED TEST
• TWEEN 80 HYDROLYSIS
2
1
RESISTANCE OF MYCOBACTERIUM
• Mycobacterium are killed at 600c in 15 – 20 mt
• In sputum they survive for 20-30hrs& in Droplets for
8 – 10 days.
• Killed by Glutaraldehyde and
Formaldehyde
• Ethanol is suitable disinfectant to superficial
surfaces and skin gloves
2
2
RESISTANCE
• Culture
At room temp- 6-8 mths
-20c – 2 yrs
• Survive in
5% phenol,15% Sulphuric acid
3% Nitric acid,5% oxalic acid, 4% Sodium
hydroxide
CYTOPLASMIC(SOLUBLE)
ANTIGEN
 Antigen 5
 Antigen 6
 Antigen 60
 Cord factor, or trehalose dimycolate, is a glycolipid molecule
found in the cell wall of Mycobacterium tuberculosis prevents
phagosome lysosome fusion
SUMMARY
 Mycobacterium Tuberculosis- Robert Koch
 Obligate Aerobes,intracellular pathogen
 Acid Fast Bacilli
 Slow Grower
 Culture Media – Solid & Liquid
 Biochemical Test
 Resistance
 Virulence Factor
POVERTY AND CROWDED LIVING SPREADS
TUBERCULOSIS
Dr.T.V.Ra
o MD
26
THANK YOU

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MYCOBACTERIUM TUBERCULOSIS-

  • 2. CONTENT  HISTORY  MORPHOLOGY structure of cell wall Acid fast bacilli  CULTURAL CHARACTERISTICS  RESISTANCE  ANTIGENIC PROPERTIES
  • 4. TUBERCULOSIS- OLDESTDISEASE Aristotle said 354-322 BC – “When one comesnear consumptives… one doescontracttheir disease… The reason is that the breath is bad and heavy…In approaching the consumptive, one breathes this pernicious air.One takes the disease because in this air there is somethingdisease producing.”
  • 6. TUBERCULOSIS KILLS NOTONLY POOR BUT RICH AND FAMOUS
  • 8. 8 WHATARE MYCOBACTERIA? • Fungus like bacteria • Obligate aerobes grows high oxygen content, such as the lungs. • Facultative intracellular pathogens usually infecting mononuclear phagocytes – Obligate parasites – Opportunist pathogens – Saprophytes
  • 9. MYCOBACTERIUM TUBERCULOSIS COMPLEX  M.tuberculosis(human tubercle bacilli)  M.bovis (bovine tubercle bacilli)  M.caprae  M.africanum  M.microtti  M.pinnipedii  M.canetti
  • 10. MORPHOLOGY OF M.TB  Slowgrowing, aerobic, non motile , non sporing, Noncapsulated .weakly Gram positive • Straight, slightly curved Rod shaped 3 x 0.3microns • May be single, in pairs or in small clumps
  • 11. CELL WALL OF M.TB
  • 12.
  • 13. ACID FAST STAINING 13 • Primary stain binds cell wall mycolic acids • Intense decolorization does not release primary stain from the cell wall of AFB • Color of AFB-based on primary stain • Counterstain provides contrasting background
  • 14. ACID FAST BACILLI –ZEIHL NEELSON STAINSTAINING 1 4
  • 15. ACID FAST BACILLI SEEN AS IN FLUORESCENT MICROSCOPE Dr.T.V.Ra o MD 1 5
  • 16. MTB : CULTURAL CHARACTERS • Grow slowly. Generation time 14-15 hrs • aerobic • > 2 weeks minimal required period • Grows at 370c do not grow below 250c or above 400c . • Phbetween 6.4 to 7.0 16
  • 17. SOLID MEDIA LIQUID MEDIA  LOWENSTEIN –JENSEN MEDIA  EGG BASED- PETRAGNINI, DORSET  BLOOD BASED- TARSHIS  SERUM BASED – LOEFFLER  POTATO BASED- PAWLOWSKY  DUBO’S  MIDDLEBROOKS  PROSKAUER,  BECKS,  SULA  SAUTONS
  • 18. Lowenstein Jensen Medium Selective. Always in screw capped bottle. Bluish Green. Contains – Egg protein – Solidifying agent Mineral salts – Mg Sulphate, Mg citrate Asparagine Malachite Green – Selective agent Sterilized by - Inspissation 1 8
  • 19. ON LIQUID MEDIUM o 19 • Appearas long serpentine cords in liquid medium • Avirulent strains grow in a more dispersed manner.
  • 20. BIOCHEMICAL TESTS • NIACIN TEST • ARYL SULPHATASE TEST • CATALASE- PEROXIDASE TEST • NITRATE REDUCTION TEST • AMIDASE TEST • PYRAZINAMIDASE TEST • INHIBITION BY T2H • NEUTRAL RED TEST • TWEEN 80 HYDROLYSIS
  • 21. 2 1 RESISTANCE OF MYCOBACTERIUM • Mycobacterium are killed at 600c in 15 – 20 mt • In sputum they survive for 20-30hrs& in Droplets for 8 – 10 days. • Killed by Glutaraldehyde and Formaldehyde • Ethanol is suitable disinfectant to superficial surfaces and skin gloves
  • 22. 2 2 RESISTANCE • Culture At room temp- 6-8 mths -20c – 2 yrs • Survive in 5% phenol,15% Sulphuric acid 3% Nitric acid,5% oxalic acid, 4% Sodium hydroxide
  • 23.
  • 24. CYTOPLASMIC(SOLUBLE) ANTIGEN  Antigen 5  Antigen 6  Antigen 60  Cord factor, or trehalose dimycolate, is a glycolipid molecule found in the cell wall of Mycobacterium tuberculosis prevents phagosome lysosome fusion
  • 25. SUMMARY  Mycobacterium Tuberculosis- Robert Koch  Obligate Aerobes,intracellular pathogen  Acid Fast Bacilli  Slow Grower  Culture Media – Solid & Liquid  Biochemical Test  Resistance  Virulence Factor
  • 26. POVERTY AND CROWDED LIVING SPREADS TUBERCULOSIS Dr.T.V.Ra o MD 26