2. Mycobacterium
• Name from Myco and
Bacteria, Fungus like
bacteria
• Because it forms mould
like growth on liquid
cultures
Dr. Ashish V. Jawarkar
3. Mycobacteria that infect humans
• M. Tuberculosis – TB
• M. Leprae – Leprosy
• Non tuberculous mycobacteria / atypical
mycobacteria
Dr. Ashish V. Jawarkar
5. Morphology
• Neither gram positive, nor negative
• Acid fast
• They have mycolic acid in their cell wall
which makes them acid fast
• Difficult to decolorise with organic acids
Dr. Ashish V. Jawarkar
13. Biochemical tests
to differentiate MTB from atypical
mycobacteria
• Niacin test –
– adding cyanogen bromide+aniline + ethanol = canary
yellow color
• Paranitrobenzoic acid
– MTB cannot grow in presence of this
• Catalase peroxidase test
– MTB is weakly positive
• Aryl sulfatase test
– Negative for MTB
Dr. Ashish V. Jawarkar
15. Treatment and Resistance
• DOTS – directly observed treatment
shortcourse
– HRZE for 4 months
– HR for 2 months
• H – isoniazid R – rifampicin Z - Pyrazinamide
• E - Ethambutol
Dr. Ashish V. Jawarkar
16. MDR-TB
• Resistant to isoniazid and rifampicin
XDR-TB
• Resistant to all drugs
Dr. Ashish V. Jawarkar
18. Pathogenicity and virulence
• Its pathogenicity is due to complex lipids
like mycolic acid in cell wall.. This makes it
–
–
–
–
–
Acid fast
Resistant to antibiotics
Resistant to disinfectants like acid and alkalis
Resistant to immune system
Resistant to destruction by macrophages
Dr. Ashish V. Jawarkar
20. Epidemiology
• Source – Humans with TB
• Spread – droplet nuclei – inhaled
• India – more than 40 percent population – that is
nearly half of us are infected
• Only saved due to our immunity
• To stop TB – RNTCP – revised national
tuberculosis control program has been started –
offering DOTS to nearly 15 million patients daily
– free of charge
Dr. Ashish V. Jawarkar
55. Lab Diagnosis
• Sample – biopsy from nasal mucosa, skin
lesions, ear lobes
• Stained with modified ZN stain – use 5%
H2SO4 instead of 20%
• Cannot be cultured
Dr. Ashish V. Jawarkar
56. LEPROMIN TEST
• Method is similar to tuberculin test
• Injected antigen is lepromin
• Reaction is read at
– 48 hours – fernandez
– 3-4 weeks - mitsuda
Dr. Ashish V. Jawarkar