1. Mycobacterium Tuberculosis Amber Garza Kaylee Stroud Jennifer Sanchez

2. Patient Viper Jackson is an inmate in a New York prison. He had complained of a dry, persistent cough and saw the doctor where a culture was taken. Later the lab reported the presence of acid fast bacteria. The culture was sent out and the identification came back Mycobacterium tuberculosis with resistance to rifampin and INH Viper Jackson is an inmate in a New York prison. He had complained of a dry, persistent cough and saw the doctor where a culture was taken. Later the lab reported the presence of acid fast bacteria. The culture was sent out and the identification came back Mycobacterium tuberculosis with resistance to rifampin and INH

3. M. Tuberculosis is known as Multi Drug Resistant Tb (MDR- Tb). M. Tuberculosis is known as Multi Drug Resistant Tb (MDR- Tb). Specific Term

4. Characteristics Cell wall composed of mycolic acid, a waxy lipid made of 60-90 carbon atoms Cell wall composed of mycolic acid, a waxy lipid made of 60-90 carbon atoms Capable of Intracellular growth Capable of Intracellular growth Are protected from lysis once they are phagocytized Are protected from lysis once they are phagocytized May remain dormant for decades inside macrophages and in the centers of tubercles. May remain dormant for decades inside macrophages and in the centers of tubercles. Acid-fast Gram Positive Bacilli Acid-fast Gram Positive Bacilli Has slow growth, divides in hours to days Has slow growth, divides in hours to days

5. Characteristics Continued Hydrophobic Hydrophobic Can live up to 8 months without a host Can live up to 8 months without a host Infects respiratory tract via inhalation of respiratory droplets Infects respiratory tract via inhalation of respiratory droplets Droplets are about 5 um in diameter. Minimum infectious dose is about 10 cells. Droplets are about 5 um in diameter. Minimum infectious dose is about 10 cells. Obligate aerobes Obligate aerobes

6. Resistance The resistance to Rifampin is a result of chromosomal mutation that alters binding site on enzyme (Bauman 305). The resistance to Rifampin is a result of chromosomal mutation that alters binding site on enzyme (Bauman 305). INH (Isonicotinic acid hydrazide) resistance is due to random mutations of bacterial chromosomes that result in reduced drug uptake or alteration of target sites (Bauman 307). INH (Isonicotinic acid hydrazide) resistance is due to random mutations of bacterial chromosomes that result in reduced drug uptake or alteration of target sites (Bauman 307).

7. DNA Exchange Image found @www.genomenewsnetwork.org/articles/11_00/TB. www.genomenewsnetwork.org/articles/11_00/TB. Courtesy The Rockefeller University M. Tuberculosis exchanges DNA by forms of Transformation. They replicate freely within macrophages slowly killing them. M. Tuberculosis exchanges DNA by forms of Transformation. They replicate freely within macrophages slowly killing them. M. tuberculosis in mouse macrophages. Courtesy Center for Tuberculosis Research, Johns Hopkins University Courtesy The Rockefeller University

8. Treatment Combination of antibiotic therapy consisting of strepmycin, ethambutol, and/or pyrazinamide. Combination of antibiotic therapy consisting of strepmycin, ethambutol, and/or pyrazinamide. If successful, treatment may take as long as two years. If successful, treatment may take as long as two years. Dots (directly observe therapy) Dots (directly observe therapy) The New York outbreak of 1990 cost over $1 billion to quell. The New York outbreak of 1990 cost over $1 billion to quell.

9. Prognosis 80% mortality rate 80% mortality rate Most likely to die from Lung Disease Most likely to die from Lung Disease If HIV positive patient will die sooner If HIV positive patient will die sooner Will die from infection of all other organs once M. Tuberculosis spreads Will die from infection of all other organs once M. Tuberculosis spreads

10. Precautions Use personal protective gear Use personal protective gear Quarantine Quarantine Monitor treatment and visit doctor frequently Monitor treatment and visit doctor frequently