Abnormal Development - Tuberculosis

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Introduction

Mycobacterium Tuberculosis (scanning EM, Image CDC)
Robert Koch (1843 - 1910) Discoverer of Mycobacterium tuberculosis, the organism that causes tuberculosis and was awarded the Nobel Prize in Physiology or Medicine in 1905.

The gram-positive bacterium Mycobacterium tuberculosis causes the disease Tuberculosis (TB) usually initially infecting the lungs. The infection can cross the placenta to infect the fetus infecting many different systems (liver, bones, kidneys, spleen, gastrointestinal tract, skin, lymph nodes).

More than two billion people, one third of the world's total population, are infected with TB bacilli, an airborne infectious disease that is preventable and curable. The Bacillus Calmette-Guérin (BCG) vaccine was first used in 1921 as a vaccine for tuberculosis disease and also used in some countries to prevent childhood tuberculous meningitis and miliary disease.

Congenital tuberculosis cases are rare with a relatively high mortality rate.[1]

Postnatal infant infection can occur as a result of inhalation of bacilli at or soon after birth, ingestion of infected breast milk, or contamination of traumatized skin or mucous membranes.


Bacterial Links: bacterial infection | Syphilis | Gonorrhea | Tuberculosis | Listeria | TORCH | Environmental | Category:Bacteria

Some Recent Findings

  • Fact and fiction in tuberculosis vaccine research: 10 years later[2] "Tuberculosis is one of the most deadly infectious diseases. The situation is worsening because of co-infection with HIV and increased occurrence of drug resistance. Although the BCG vaccine has been in use for 90 years, protection is insufficient; new vaccine candidates are therefore needed. 12 potential vaccines have gone into clinical trials."
  • Increased risk of low birthweight and small for gestational age infants among women with tuberculosis[3] "We concluded that women diagnosed with TB during pregnancy are at increased risk for having low birthweight (LBW) and small for gestational age (SGA) babies, compared with unaffected mothers. We suggest that clinicians should make women with TB aware of the potential risks before planning a child."
More recent papers
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Search term: Tuberculosis

Fatma Ben Abid, Mohammed Abukhattab, Hafedh Ghazouani, Obada Khalil, Ahmed Gohar, Hussam Al Soub, Muna Al Maslamani, Abdullatif Al Khal, Eman Al Masalamani, Said Al Dhahry, Samar Hashim, Faraj Howadi, Adeel A Butt Epidemiology and Clinical Outcomes of Viral Central Nervous System Infections. Int. J. Infect. Dis.: 2018; PubMed 29913285

Kenechukwu Chudy-Onwugaje, Fauzia Vandermeer, Sandra Quezada Mimicking Abdominal Tuberculosis: Abdominal Abscess Caused by Lawsonella Clevelandensis in IBD. Clin. Gastroenterol. Hepatol.: 2018; PubMed 29913279

Bernice J Klotoe, Barbara Molina-Moya, Harrison Magdinier Gomes, Michel K Gomgnimbou, Lorenna Oliveira Suzarte, Maria H Féres Saad, Sajid Ali, José Dominguez, Edita Pimkina, Elena Zholdybayeva, Christophe Sola, Guislaine Refrégier TB-EFI, a novel 18-Plex microbead-based method for prediction of second-line drugs and ethambutol resistance in Mycobacterium tuberculosis complex. J. Microbiol. Methods: 2018; PubMed 29913189

Lázaro Moreira Marques Neto, Nicholas Zufelato, Ailton Antônio de Sousa-Júnior, Monalisa Martins Trentini, Adeliane Castro da Costa, Andris Figueiroa Bakuzis, André Kipnis, Ana Paula JunqueiraKipnis Specific T cell induction using iron oxide based nanoparticles as subunit vaccine adjuvant. Hum Vaccin Immunother: 2018;1-56 PubMed 29913109

Louis S Ates, Fadel Sayes, Wafa Frigui, Roy Ummels, Merel P M Damen, Daria Bottai, Marcel A Behr, Jeroen W J van Heijst, Wilbert Bitter, Laleh Majlessi, Roland Brosch RD5-mediated lack of PE_PGRS and PPE-MPTR export in BCG vaccine strains results in strong reduction of antigenic repertoire but little impact on protection. PLoS Pathog.: 2018, 14(6);e1007139 PubMed 29912964

Global Tuberculosis (new cases 2007)

WHO Report 2007 - Global tuberculosis new cases 2007.jpg

Drug-Resistant Tuberculosis

Extensively drug-resistant tuberculosis (XDR-TB2) is a highly drug-resistant strain subset of multidrug-resistant TB (MDR-TB) that have significantly worse outcomes, has now been reported in more than 50 countries. (WHO data)

Multidrug-resistant tuberculosis (MDR-TB) is defined as resistance to the two most powerful first-line anti-TB drugs (isoniazid and rifampicin).

Extensively drug-resistant tuberculosis (XDR-TB2) is defined as MDR-TB plus resistance to the most powerful second-line anti-TB drugs (any fluoroquinolone and any of the three injectable drugs: amikacin, capreomycin and kanamycin).


Australian Recommendations

BCG vaccination is not recommended for general use in the Australian population.

BCG is recommended for:

  1. Aboriginal neonates in areas of high incidence of TB (e.g. Northern Territory, Far North Queensland, northern areas of Western Australia and South Australia).
  2. neonates and children 5 years and under who will be travelling or living in countries or areas with a high prevalence of TB for extended periods.
  3. neonates born to parents with leprosy or a family history of leprosy.

In addition to these recommendations BCG may be considered in the following:

  1. Children over 5 years who will be travelling or living in countries or areas with a high prevalence of TB for extended periods.
  2. Health care workers (HCWs) who may be at high risk of exposure to drug resistant cases.

(Text Source: Communicable Diseases Intelligence Volume 30 Number 1, March 2006 - The BCG vaccine: information and recommendations for use in Australia)

References

  1. Wansheng Peng, Juan Yang, Enmei Liu Analysis of 170 cases of congenital TB reported in the literature between 1946 and 2009. Pediatr. Pulmonol.: 2011, 46(12);1215-24 PubMed 21626715
  2. Stefan H E Kaufmann Fact and fiction in tuberculosis vaccine research: 10 years later. Lancet Infect Dis: 2011, 11(8);633-40 PubMed 21798463
  3. H-C Lin, H-C Lin, S-F Chen Increased risk of low birthweight and small for gestational age infants among women with tuberculosis. BJOG: 2010, 117(5);585-90 PubMed 20156210

Reviews

S Borrell, S Gagneux Strain diversity, epistasis and the evolution of drug resistance in Mycobacterium tuberculosis. Clin. Microbiol. Infect.: 2011, 17(6);815-20 PubMed 21682802


Articles

Erdal Peker, Erol Bozdoğan, Murat Doğan A rare tuberculosis form: congenital tuberculosis. Tuberk Toraks: 2010, 58(1);93-6 PubMed 20517736

Z Neyaz, A Gadodia, S Gamanagatti, M Sarthi Imaging findings of congenital tuberculosis in three infants. Singapore Med J: 2008, 49(2);e42-6 PubMed 18301825

Liana Consuelo Santana Vilarinho Congenital tuberculosis: a case report. Braz J Infect Dis: 2006, 10(5);368-70 PubMed 17293929

Albert Chen, Shin-Lin Shih Congenital tuberculosis in two infants. AJR Am J Roentgenol: 2004, 182(1);253-6 PubMed 14684547

Jody Stähelin-Massik, Thierry Carrel, Andrea Duppenthaler, Georg Zeilinger, Hanspeter E Gnehm Congenital tuberculosis in a premature infant. Swiss Med Wkly: 2002, 132(41-42);598-602 PubMed 12571760


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Cite this page: Hill, M.A. (2018, June 20) Embryology Abnormal Development - Tuberculosis. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Tuberculosis

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