Page 194 - Review of Medical Microbiology and Immunology ( PDFDrive )

mebooksfree.com

mebooksfree.com
mebooksfree.com
mebooksfree.com
mebooksfree.com
mebooksfree.com mebooksfree.com mebooksfree.com mebooksfree.com C H mebooksfree.com mebooksfree.com
mebooksfree.com
21
P
A
R
E
T

Mycobacteria

mebooksfree.com mebooksfree.com mebooksfree.com Self-Assessment Questions mebooksfree.com mebooksfree.com
mebooksfree.com

CHAPTER C ONTENT S

Introduction
Summaries of Organisms
Mycobacterium tuberculosis
Atypical Mycobacteria
Practice Questions: USMLE & Course Examinations
Mycobacterium leprae

INTRODUCTION cause of leprosy. Atypical mycobacteria, such as Mycobacte-
mebooksfree.com
mebooksfree.com mebooksfree.com mebooksfree.com Mycobacterium chelonae, occasionally cause human disease mebooksfree.com
mebooksfree.com
rium avium-intracellulare complex and Mycobacterium
Mycobacteria are aerobic, acid-fast bacilli (rods) (Figure 21–1).
kansasii, can cause tuberculosis-like disease but are less
They are neither gram-positive nor gram-negative (i.e.,
frequent pathogens. Rapidly growing mycobacteria, such as
they are stained poorly by the dyes used in Gram stain).
They are virtually the only bacteria that are acid-fast. (One
in immunocompromised patients or those in whom pros-
exception is Nocardia asteroides, the major cause of nocar-
thetic devices have been implanted (Table 21–1). The clini-
diosis, which is also acid-fast.) The term acid-fast refers to
cal features of three important mycobacteria are described
an organism’s ability to retain the carbolfuchsin stain
in Table 21–2.
despite subsequent treatment with an ethanol–hydrochloric
Additional information regarding the clinical aspects of
acid mixture. The high lipid content (approximately 60%)
infections caused by the organisms in this chapter is pro-
of their cell wall makes mycobacteria acid-fast.
vided in Part IX entitled Infectious Diseases beginning on
The major pathogens are Mycobacterium tuberculosis,
page 593.
the cause of tuberculosis, and Mycobacterium leprae, the
mebooksfree.com mebooksfree.com mebooksfree.com MYCOBACTERIUM TUBERCULOSIS mebooksfree.com
mebooksfree.com
mebooksfree.com
Disease
This organism causes tuberculosis. Worldwide, M. tubercu-
losis causes more deaths than any other single microbial
agent. Approximately one-third of the world’s population is
infected with this organism. Each year, it is estimated that
1.7 million people die of tuberculosis and that 9 million
new cases occur. An estimated 500,000 people are infected
with a multidrug-resistant strain of M. tuberculosis.
Important Properties
mebooksfree.com
mebooksfree.com mebooksfree.com mebooksfree.com Mycobacterium tuberculosis grows slowly (i.e., it has a dou- 183 mebooksfree.com
mebooksfree.com
bling time of 18 hours, in contrast to most bacteria, which
can double in number in 1 hour or less). Because growth is
FIGURE 21–1
Mycobacterium tuberculosis—acid-fast stain.
so slow, cultures of clinical specimens must be held for 6 to
Long red rods of M. tuberculosis are seen on a blue background.
8 weeks before being recorded as negative. Mycobacterium
(Source: Dr. George Kubica, Public Health Image Library, Centers for Disease
tuberculosis can be cultured on bacteriologic media,
Control and Prevention.)

mebooksfree.com mebooksfree.com mebooksfree.com mebooksfree.com mebooksfree.com mebooksfree.com