Digging Deeper into Bacteria Discuss the mycobacteria and normal flora. Digging Deeper into Bacteria Part 3 of 3: Mycobacteria and Normal Flora

Normal Flora (a.k.a. indigenous flora) See table 7-4 in your textbook for a list of normal flora Term used to describe microbes that commonly live in parts of the human body including: Respiratory tract Gastrointestinal tract Skin Some are: Symbiotic Opportunistic Neither helpful nor harmful

Mycobacterium Basics Easily to identified by the prefix “myco” Include microbes responsible for leprosy and tuberculosis All are acid-fast Will not stain using regular gram techniques Acid fast is known as the Ziehl-Neelson test Sputum should be collected every morning for three days to rule out or confirm tuberculosis All are aerobic

Mycobacterium tuberculosis Aerobic bacillus Causes tuberculosis (TB) Tubercles form in the lungs and cause difficulty breathing and hemoptysis Most known for infecting lungs but may infect nearly any body part including bones and organs Mummies in both Egypt and Peru have been found with spinal tuberculosis Tubercle definition: http://dictionary.reference.com/browse/tubercle Hemoptysis definition: http://dictionary.reference.com/browse/hemoptysis

M. tuberculosis History Most strains are multi-drug resistant (MDR) Extremely drug resistant (XDR) strain is often fatal TB kills many people worldwide daily 10% of people who become infected with TB become symptomatic (i.e. get active TB) 50% of them will die from TB

M. tuberculosis resources In the U.S., patients with AIDS or other immune diseases are considered high risk The CDC monitors TB therapy in the U.S. For more information on TB: Mountains Beyond Mountains: Healing the World: The Quest of Dr. Paul Farmer by Tracy Kidder XDR TB video Tuberculosis, The Silent Killer video XDRTB.org with TED talk winner video - powerful images For a local history of TB watch Sanitorium Scenes XDR TB video: http://www.youtube.com/watch?v=INdBNgOc5ls&feature=related TB Silent Killer video: http://www.youtube.com/watch?v=149H13ocPqw TED Talk video: http://xdrtb.org/ Sanitorium Scenes: http://www.youtube.com/watch?v=DxsdV86pRSw

Chest x-ray shows right upper lobe consolidation caused by TB. Common for TB to start in the upper portions of the lungs and work its way down. This is uncommon of many other consolidations. M. tuberculosis

M. Tuberculosis Test PPD shown on the left; results shown on the right

Mycoplasma pneumoniae Pleomorphic Causes pneumonia Slow onset Long duration even with medication treatment Causes upper and lower respiratory tract infections usually in late summer and early fall Community acquired Often presents similarly to Legionnaire‘s

Mycobacterium Summary Tuberculosis is the most important mycobacterium to know though you may see patients with M. pneumoniae more frequently. Tuberculosis seems scary with its antibiotic resistance Rarely contracted by non-immune suppressed individuals. Most hospitals will have you tested for TB every 6-12 months. Many opportunities for healthcare workers to get involved with the worldwide fight against tuberculosis.

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