Mycobacterium tuberculosis complex (tuberculosis)

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Mycobacterium tuberculosis complex (tuberculosis)

What is Mycobacterium tuberculosis?

Tuberculosis pathogens are bacteria from the Mycobacteriaceae family, Genus Mycobacterium. They are aerobic, immobile, rod-shaped and slow-growing. The Mycobacterium tuberculosis complex consists of the species M. africanum, M. bovis (ssp. Bovis and caprae), M. canetti, M. microti, M. pinnipedii, M. tuberculosis and the vaccine strain M. bovis BCG. An infection in humans is most frequently caused by the pathogen M. tuberculosis.

Along with AIDS/HIV and malaria, tuberculosis is one of the world’s most common infectious diseases. According to the World Health Organization (WHO), nine million people are infected with tuberculosis every year. About one-quarter of the world’s population is infected with the tuberculosis pathogen. Although tuberculosis is treatable, 1.4 million people die every year as a result of the disease. The reason for this is often that people who affected are not treated sufficiently or are also infected with HIV.

Humans provide the main reservoir for tuberculosis, but the pathogen can also be found in cattle, small rodents and certain species of seals.

How is tuberculosis transmitted?

Tuberculosis is transmitted almost exclusively through airborne droplets or particles. In 80 per cent of cases, the infection is caused by a patient with open tuberculosis of the lung. Open pulmonary tuberculosis is called tuberculosis when the focus of the disease is so close to the respiratory tract that bacteria are released into the environment by breathing, speaking and above all, coughing and sneezing.

However, whether a tuberculosis infection occurs depends strongly on how much time a person has spent near a tuberculosis patient, how many pathogens he has inhaled and how susceptible he is to the pathogens. Tuberculosis pathogens are transmitted less quickly than, for example, varicella or measles. If tuberculosis affects organs other than those of the respiratory tract, it is usually not transmitted. Transmission from cattle to humans is possible by drinking non-pasteurised milk.

What are the symptoms of the disease?

In most cases, tuberculosis manifests itself through a prolonged cough. This is occasionally accompanied by chest pain and shortness of breath, as well as flu-like symptoms such as lack of appetite, mild fever, fatigue and general weakness.

However, since tuberculosis can affect any organ of the body, the clinical picture is also very varied. There is no characteristic complaint for tuberculosis. If the disease has affected other organs, tuberculosis can cause organ-specific symptoms even years later.

Significance for infections in hospitals and in the outpatient sector

Toddlers, infants and HIV patients in particular are at greater risk of tuberculosis. Due to the weakened immune system of HIV patients, tuberculosis is particularly dangerous for them and is the leading cause of death for HIV-infected persons. As with HIV patients, tuberculosis in infants and young children spreads particularly frequently to other organs. For inpatients, placement in an isolation room with an anteroom is recommended, and the following hygiene measures should be applied: Hand and surface disinfection, disposable gloves and protective gowns as well as FFP3 masks for respiratory protection.

According to the US Centers for Disease Control and Prevention (CDC), all healthcare settings, particularly those in which people are at high risk for exposure to tuberculosis, should develop policies and procedures for tuberculosis control. These should be reviewed periodically and evaluated for effectiveness to determine the actions necessary to minimise the risk for transmission of tuberculosis.

Survival time of pathogens on inanimate surfaces

1 day to 4 months for M. tuberculosis and more than 2 months for M. bovis

Disinfectant effectiveness for prevention

The required spectrum of activity against tuberculosis bacteria is: tuberculocidal

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