Introduction and Classification

Intro and classification of Anti tubercular agents
Introduction:
Tuberculosis (TB) is a multisystemic infectious disease caused by Mycobacterium tuberculosis

(or TB, TB germs), a rod-shaped bacterium.
The bacteria may stain weakly both gram-negative and gram-positive due to its cell surface so
medical professionals use acid-fast stains to visualize the cells with a microscope.
Tuberculosis (TB) is an infectious disease usually caused by the bacterium Mycobacterium

tuberculosis (MTB).
 Tuberculosis generally affects the lungs, but can also affect other parts of the body.
 Most infections do not have symptoms, in which case it is known as latent tuberculosis.
 Latent tuberculosis infection (LTBI) means a patient is infected with Mycobacterium
tuberculosis, but the patient does not have active tuberculosis.
 About 10% of latent infections progress to active disease which, if left untreated, kills
about half of those infected.
 The classic symptoms of active TB are a chronic cough with blood-containing sputum,
fever, night sweats, and weight loss.
 Tuberculosis is spread through the air when people who have active TB in their lungs
cough, spit, speak, or sneeze. People with latent TB do not spread the disease.
 Active infection occurs more often in people with HIV/AIDS and in those who smoke.
 Diagnosis of active TB is based on chest X-rays, as well as microscopic examination and
culture of body fluids. Diagnosis of latent TB relies on the tuberculin skin test (TST) or
blood tests.
.
History:
 TB has likely been infecting humans for many centuries; evidence of TB infections has
been found in cadavers that date back to about 8000 BC.
 The Greeks termed it as a wasting away disease (phthisis).
 For many European countries, TB caused death in about 25% of adults and was the
leading cause of death in the U.S. until the early 1900s.
 Robert Koch discovered TB's cause, Mycobacterium tuberculosis, in 1882.
 With increased understanding of TB, public health initiatives, treatment methods like
isolation of patients (quarantine), and the development of drugs to treat TB, the incidence
of the disease, especially in developed countries, has been markedly reduced.
 However, the CDC estimates one-third of the world's population is infected with TB with
about 1.8 million deaths per year.
 About 60% of all TB-infected people are located in India, Indonesia, China, Nigeria,
Pakistan, and South Africa.
 TB (TB may stand for the disease or the bacteria that cause the disease) is the most
common cause of infectious disease-related mortality worldwide (about 10 million people
MC-3 SCP N.ASTALAKSHMI

worldwide were sick with TB in 2017, and about 1.3 million people died from TB
worldwide in 2017 according to the World Health Organization [WHO] and the CDC).
 HIV-associated TB infections are a leading cause of death in HIV patients
DIAGNOSIS:
 A small amount of a substance called PPD tuberculin is injected just below the skin of
your inside forearm. You should feel only a slight needle prick.
 Within 48 to 72 hours, a health care professional will check your arm for swelling at the
injection site. A hard, raised red bump means you're likely to have TB infection. The size
of the bump determines whether the test results are significant.
Blood tests
Blood tests may be used to confirm or rule out latent or active tuberculosis. These tests use
sophisticated technology to measure your immune system's reaction to TB bacteria.
Imaging tests
If you've had a positive skin test, your doctor is likely to order a chest X-ray or a CT scan. This
may show white spots in your lungs where your immune system has walled off TB bacteria, or it
may reveal changes in your lungs caused by active tuberculosis. CT scans provide more-detailed
images than do X-rays.
Sputum tests
If your chest X-ray shows signs of tuberculosis, your doctor may take samples of your sputum —
the mucus that comes up when you cough. The samples are tested for TB bacteria.
Sputum samples can also be used to test for drug-resistant strains of TB. This helps your doctor
choose the medications that are most likely to work. These tests can take four to eight weeks to
be completed.
Mycobacterium
 Mycobacteria are designated as the transition forms existing between bacteria
and fungi.
 The Greek prefix “myco” - means "fungus" alluding to the way mycobacteria
have been observed to grow in a mold-like fashion on the surface of cultures. It
has a positive gram stain and a spirochete spine.
 Mycobacterium refers to a genus of acid-fast organisms.
 Mycobacteria are aerobic and non-motile bacteria.

 Mycobacterium is a genus of Actinobacteria, given its own family, the

Mycobacteriaceae. This genus includes pathogens known to cause serious
diseases in mammals, including tuberculosis (Mycobacterium tuberculosis) and
leprosy (Mycobacterium leprae) in humans.
Robert Koch discovered the tuberculosis bacillus.

Albert Calmette and Camille Guérin achieved the first genuine success in immunization against
tuberculosis in 1906, using attenuated bovine-strain tuberculosis. It was called Bacille Calmette–
Guérin (BCG). The BCG vaccine was first used on humans in 1921 in France
Common infection sites of the tuberculosis :

- Common infections of TB are lungs (primary site), brain, bone, liver, and kidney. The main
symptoms are cough, tachycardia, cyanosis and respiratory failure. Depending upon the site of
infection, the disease can be categorized as follows:
o Pulmonary tuberculosis (respiratory tract).
o Genitourinary tuberculosis (genitourinary tract).
o Tuberculous meningitis (nervous system).
o Miliary tuberculosis (a widespread infection).
Drugs used in the treatment of tuberculosis

- Drugs used in the treatment of tuberculosis can be divided into two major categories:
1. First-line drugs: Isoniazid, streptomycin, rifampicin, ethambutol, and pyrazinamide.
2. Second-line drugs: Ethionamide, p-amino salicylic acid, ofloxacin, ciprofloxacin,
cycloserine, amikacin, kanamycin, viomycin, and capreomycin
Comparison between cell envelopes of mycobacteria and other bacteria
(a) The innermost layer of the mycobacterial cell envelope is composed of peptidoglycan and is lined by
a layer of arabinogalactan. The presence of mycolic acids covalently bound to arabinogalactan, aswell as
the interaction of glycolipids and lipoglycans with mycolic acids in the outer layer, confers high
hydrophobicity to the mycobacterial cell wall
(b) Gram-negative cell walls contain a thin peptidoglycan layer that lines the plasma membrane and an
outer membrane composed of lipopolysaccharides, responsible for their antigenic properties;
(c) The cell walls of Gram-positive bacteria are thick and mainly composed of a peptidoglycan layer
adjacent to the plasma membrane.
Signs and symptoms of active TB include:
 Coughing that lasts three or more weeks

 Coughing up blood

 Chest pain, or pain with breathing or coughing

 Unintentional weight loss
 Fatigue
 Fever
 Night sweats
 Chills
 Loss of appetite


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Intro and classification of Anti tubercular agents

Tuberculosis (TB) is a multisystemic infectious disease caused by Mycobacterium tuberculosis

Tuberculosis (TB) is an infectious disease usually caused by the bacterium Mycobacterium

MC-3 SCP N.ASTALAKSHMI

MC-3 SCP N.ASTALAKSHMI

 Mycobacterium is a genus of Actinobacteria, given its own family, the

Robert Koch discovered the tuberculosis bacillus.

Common infection sites of the tuberculosis :

Drugs used in the treatment of tuberculosis

Comparison between cell envelopes of mycobacteria and other bacteria

Signs and symptoms of active TB include:

 Coughing that lasts three or more weeks

MC-3 SCP N.ASTALAKSHMI

 Chest pain, or pain with breathing or coughing

MC-3 SCP N.ASTALAKSHMI

MC-3 SCP N.ASTALAKSHMI

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