Tuberculosis: A Clinical Practice Guide

Microbiology of Tuberculosis

Author(s): Rafael Laniado-Laborín

Pp: 7-11 (5)

DOI: 10.2174/9789811488511120010005

* (Excluding Mailing and Handling)

Abstract

Mycobacterium tuberculosis (MTB) is the primary etiological agent of tuberculosis in humans (since the disease may be due to other mycobacteria of the MTB complex such as M. bovis). It belongs to the order of the Actinomycetales and the Mycobacteriaceae family. It is a bacillus that lacks capsule or flagella and does not produce spores or toxins; it measures 0.5 by four microns. Its generation time is prolonged (up to 24 hours). It is an aerobic bacillus that, if necessary, can persist under anaerobic conditions.

It has a cell wall of extremely complex composition, with great strength and thickness, constituted up to 60% by lipids, generally known as mycolic acids that form complexes with polysaccharides such as arabinogalactan and peptidoglycan; these lipids determine their resistance to discoloration by alcohol-acid after they have been stained with carbol fuchsin (hence the term acid-fast bacilli acid or AFB). A distinctive feature of the MTB cell wall is its content of N-glycolimuranic acid instead of N-acetylmuramic acid found in most bacteria.

The unusual cell wall of MTB also allows it to survive initially in the macrophage. The cell wall also constitutes a robust and highly impermeable barrier to harmful compounds and drugs. MTB can sense when the local tissue conditions are inadequate for survival (low oxygen tension and nutrient depletion), as in the macrophages and granulomas, responding by the activation of a dormant state, in which the bacilli stop multiplying, down-regulates its metabolism and activates anaerobic metabolism.


Keywords: Acid-fast bacilli, Granulomas, Mycobacterium tuberculosis, Mycolic acids.

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      • 11. app/Models/ContentAccess.php:647
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      • 11. app/Models/ContentAccess.php:647
      • 12. app/Http/Controllers/ChapterController.php:1478
      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 14. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59424481 and j.to_ip >=59424481 )) and ((j.from_date <= 1740551471 and j.to_date >= 1740551471 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 14364) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59424481 and j.to_ip >=59424481 )) and ((j.from_date <= 1740551471 and j.to_date >= 1740551471 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 14364) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59424481 and j.to_ip >=59424481 )) and ((j.from_date <= 1740551471 and j.to_date >= 1740551471 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 14364)
      610μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 2923 and `b`.`banner_from_date` <= 1740551471 and `b`.`banner_to_date` >= 1740551471 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.09msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 2923
      • 3: 1740551471
      • 4: 1740551471
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='14557386da9919ec1c8e78e798cf7589'
      240μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    4Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        tgkc8T2nSGyGeDVPB8BiQwLvO8W8OMQaYuaogjwD
        uc_cart_id
        14557386da9919ec1c8e78e798cf7589
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/14364" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
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        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
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        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Wed, 26 Feb 2025 06:31:11 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6ImU1UEQveXdYMXdjUkZBV2NTTndBc0E9PSIsInZhbHVlIjoiUy8ya3kvTWNvQ2F6VlRzaVdWdWtBTzRoVEQ2VkpqUDJYOHJIcjNVRWRnK3BpN2NSaThxTzhWUlVETEFuZWs0TTBCYXlqeVh6bnZKZVp4eFB0Y2Z6RFJBMFgxRU14dW9veUpyeDNkejJKd2ZDNEk4VnNRdHJoSk14OHJUQ0VpamYiLCJtYWMiOiI3MDViMThkMzk1Nzc3Y2M3YWY2ZjhiZjI1NGJiODAxZmNjMDZiNjA5NGU5NmQwNzM4YzE4Nzc4Y2ZhZjIwNzlhIiwidGFnIjoiIn0%3D; expires=Fri, 28 Feb 2025 18:31:11 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6ImU1UEQveXdYMXdjUkZBV2NTTndBc0E9PSIsInZhbHVlIjoiUy8ya3kvTWNvQ2F6VlRzaVdWdWtBTzRoVEQ2VkpqUDJYOHJIcjNVRWRnK3BpN2NSaThxTzhWUlVETEFuZWs0TTBCYXlqe" 1 => "alphaeurekaselectnet_session=eyJpdiI6ImwvTkxpUU1KR2hrUHVNbnIwZ2NpZmc9PSIsInZhbHVlIjoieGxkVjAveS9xNERTWVNGekJhYmlyQVg1dTlkU0k4QXhwWTNpMXFhQzl2Mm8xVWxTd3l3Y0gyYjhVaE83dkcyZTZNWTRza0ZIbmpTaVA1Vyt0dnZKb1FSU1dsRVU3UHcxWDdseEVpdkVsdmxISWxzYmFCa25WWk9zMkJwSDVhQlMiLCJtYWMiOiJiMTdjMGIzYzQ3M2Q4ZWRlZmFjMDJlMGIxY2YzNTMzNTEzMDBlMmM1ZjQ2OWZiZGIzYWNjZjIxMDI0NWNiOTA5IiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6ImwvTkxpUU1KR2hrUHVNbnIwZ2NpZmc9PSIsInZhbHVlIjoieGxkVjAveS9xNERTWVNGekJhYmlyQVg1dTlkU0k4QXhwWTNpMXFhQzl2Mm8xVWxTd3l3Y0gyYjh" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6ImU1UEQveXdYMXdjUkZBV2NTTndBc0E9PSIsInZhbHVlIjoiUy8ya3kvTWNvQ2F6VlRzaVdWdWtBTzRoVEQ2VkpqUDJYOHJIcjNVRWRnK3BpN2NSaThxTzhWUlVETEFuZWs0TTBCYXlqeVh6bnZKZVp4eFB0Y2Z6RFJBMFgxRU14dW9veUpyeDNkejJKd2ZDNEk4VnNRdHJoSk14OHJUQ0VpamYiLCJtYWMiOiI3MDViMThkMzk1Nzc3Y2M3YWY2ZjhiZjI1NGJiODAxZmNjMDZiNjA5NGU5NmQwNzM4YzE4Nzc4Y2ZhZjIwNzlhIiwidGFnIjoiIn0%3D; expires=Fri, 28-Feb-2025 18:31:11 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6ImU1UEQveXdYMXdjUkZBV2NTTndBc0E9PSIsInZhbHVlIjoiUy8ya3kvTWNvQ2F6VlRzaVdWdWtBTzRoVEQ2VkpqUDJYOHJIcjNVRWRnK3BpN2NSaThxTzhWUlVETEFuZWs0TTBCYXlqe" 1 => "alphaeurekaselectnet_session=eyJpdiI6ImwvTkxpUU1KR2hrUHVNbnIwZ2NpZmc9PSIsInZhbHVlIjoieGxkVjAveS9xNERTWVNGekJhYmlyQVg1dTlkU0k4QXhwWTNpMXFhQzl2Mm8xVWxTd3l3Y0gyYjhVaE83dkcyZTZNWTRza0ZIbmpTaVA1Vyt0dnZKb1FSU1dsRVU3UHcxWDdseEVpdkVsdmxISWxzYmFCa25WWk9zMkJwSDVhQlMiLCJtYWMiOiJiMTdjMGIzYzQ3M2Q4ZWRlZmFjMDJlMGIxY2YzNTMzNTEzMDBlMmM1ZjQ2OWZiZGIzYWNjZjIxMDI0NWNiOTA5IiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6ImwvTkxpUU1KR2hrUHVNbnIwZ2NpZmc9PSIsInZhbHVlIjoieGxkVjAveS9xNERTWVNGekJhYmlyQVg1dTlkU0k4QXhwWTNpMXFhQzl2Mm8xVWxTd3l3Y0gyYjh" ] ]
        session_attributes
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        array:5 [ "_token" => "tgkc8T2nSGyGeDVPB8BiQwLvO8W8OMQaYuaogjwD" "uc_cart_id" => "14557386da9919ec1c8e78e798cf7589" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/14364" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-26 06:31:11GET/chapter/14364112196