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Mycobacterium tuberculosis Mycobacterium Obligate aerobes, (causing disease in highly oxygenated tissues such as the upper lobe of the lung and the kidney.) Grow slowly, (generation time of 15-20 hours, cultures of clinical specimens must be held for 6-8 weeks before being recorded as negative), Hideous colonies. On solid media the colonies are raised and rough with a wrinkled surface (Colony with a waxy, warty appearance) Resistance M.tuberculosis is relatively resistant to acids and alkalis. M.tuberculosis is resistant to dehydration Resistant to common antibiotics and antimycobacterial drug, isoniazid, Low infection dose (1-3 bacilli reaching the lung alveolar space can initiate an infection) facultative intracellular pathogen: inhibits phagosome-lysosome fusion, intracellular growth in alveolar macrophages distributed within macrophages ---sustain life-long infection, Disease symptoms mostly caused by immune reaction to infection (There are not endotoxin and cannot produce exotoxin or invasive enzyme ) Pathogenicity concerned with some constituents of cell wall and some toxic substances of tubercle bacilli. Mycobacteria are rich in lipids, Lipid closely related to virulence and responsible for acid-fastness. Long-chain (C78-C90) fatty acids called mycolic acids contribute to the organism’s acid-fastness Sulfatide硫酸脑苷脂 : inhibits phagosome-lysosome fusion, intracellular growth in macrophages and survive for long time Wax D adjuvant (not only to TB), delayed-type hypersensitivity Phosphatides磷脂 , which play a role in caseation necrosis. Cord factor (trehalose-6,6-dimycolate) cause chronic granulomatosis , suppress WBC wandering Proteins: elicit the tuberculin reaction. Polysaccharides: Their role in the pathogenesis of disease is uncertain. 2. Secondary tuberculosis in the elderly or immunosuppressed individuals who have had primary infection Endogenous infection- the reactivation of the bacilli that survived in the primary tube
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