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A. M.tuberculosis (Mtb) takes about 12h to 18h to do a cell division. This partially explains why it takes so long to grow the bacteria for diagnosis (4-6 weeks). How can this impact treatment? Be precise. B. Which group of patients will be the most challenging to treat? Explain why you chose that group? Be precise.

A. M.tuberculosis (Mtb) takes about 12h to 18h to do a cell division. This partially explains why it takes so long to grow the bacteria for diagnosis (4-6 weeks). How can this impact treatment? Be precise. B. Which group of patients will be the most challenging to treat? Explain why you chose that group? Be precise.

Human Anatomy & Physiology (11th Edition)
Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
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Problem 1RQ: The correct sequence of levels forming the structural hierarchy is A. (a) organ, organ system,...
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Table 1: Lily's data Total Antibiotic resistance (R) / sensitivity (S) Pyrazinamide number Isoniazid Rifampin Ethambutol Kanamycin МоxiПlохасin Capreomycin of patient isolates Inhibits Inhibits Inhibits cell Interferes with Inhibits Inhibits DNA Mechanism of DNA metabolism replication protein synthesis cell wall wall action formation replication formation unclear Group A (n = 32) 9 R R R S S 3 R S R S S R 3 R S S S 4 R R S R S S R R R S S S S 2 R R R S 1 R S S S S S 2 R R S 1 R R S R R R 1 R R S Group B (n = 30) 3 R R S 2 R S S R S S 1 R S R S R S S 1 R S S S R S S 7 R S S S 3 S R S R S S S 1 R S S S S 2 S S R S S S 1 S S R S S a Tested and defined using standard protocols 9 S S S S Practice Question #10 p. 225 A. M.tuberculosis (Mtb) takes about 12h to 18h to do a cell division. This partially explains why it takes so long to grow the bacteria for diagnosis (4-6 weeks). How can this impact treatment? Be precise. B. Which group of patients will be the most challenging to treat? Explain why you chose that group? Be precise.
Transcribed Image Text:Table 1: Lily's data Total Antibiotic resistance (R) / sensitivity (S) Pyrazinamide number Isoniazid Rifampin Ethambutol Kanamycin МоxiПlохасin Capreomycin of patient isolates Inhibits Inhibits Inhibits cell Interferes with Inhibits Inhibits DNA Mechanism of DNA metabolism replication protein synthesis cell wall wall action formation replication formation unclear Group A (n = 32) 9 R R R S S 3 R S R S S R 3 R S S S 4 R R S R S S R R R S S S S 2 R R R S 1 R S S S S S 2 R R S 1 R R S R R R 1 R R S Group B (n = 30) 3 R R S 2 R S S R S S 1 R S R S R S S 1 R S S S R S S 7 R S S S 3 S R S R S S S 1 R S S S S 2 S S R S S S 1 S S R S S a Tested and defined using standard protocols 9 S S S S Practice Question #10 p. 225 A. M.tuberculosis (Mtb) takes about 12h to 18h to do a cell division. This partially explains why it takes so long to grow the bacteria for diagnosis (4-6 weeks). How can this impact treatment? Be precise. B. Which group of patients will be the most challenging to treat? Explain why you chose that group? Be precise.
Practice Case study p. 224 part: Tuberculosis (TB) in indigenous populations. Lily was a recent science graduate of the University of Alberta and was 11 months into her 12 - month Master of Science in Global Health degree, at Dalhousie University. This relatively new program was created to provide the multidisciplinary training required of scientists working to meet the complex challenges of global public health issues. The University had partnered with the National Collaborating Centre for Indigenous Health (NCCIH) and that was why Lily now found herself doing her Global Health Field Practicum in the Northern Territories, working on a study of drug resistant TB infections among Innuit communities. The different communities included in her research were close to 7000 individuals, with multiple diagnosed cases of TB. And while she was grateful that drug-resistant TB in Canada remained below the global average (Public Health Agency of Canada, 2019), she was cognizant of the possibility that this might not always be the case for Indigenous peoples. In addition, much to our national shame, she knew that the rate of TB among Canadian born Indigenous Peoples was higher than that of Canadian born non-Indigenous people; those worst affected were the Inuit communities, at a shocking 300x higher rate of infection. In fact, incidence rates for 2016 were as follows: 0.6 per 100,000 among Canadian-born, non-Indigenous people. per 100,000 among all First Nations people. 170.1 per 100,000 among Inuit. 2.1 per 100,000 among Métis people. It had been hypothesized that drug resistance was one of the reasons for the increased incidence and mortality rates and the failure of the standard DOT strategy (Directly Observed Treatment), part of the World Health Organization's (WHO) strategy for global eradication of TB. That's where Lily came in: the existence and extent of multi-drug resistant (MDR) TB had not been documented. So, her project was to do just that. Lily was studying two groups of TB patients – one group (group A) included 32 patients who were not responding to DOTS. Her control (group B) consisted of 30 patients who were presumptively diagnosed with TB based on symptoms and a positive sputum smear using acid-fast staining. Group B had just started treatment. Her experimental strategy was quite simple – isolate Mycobacterium tuberculosis from patient sputum samples and determine the resistance of the isolated strains to rifampicin, isoniazid, pyrazinamide, and ethambutol, as well as the antibiotics kanamycin, moxifloxacin and capreomycin. Because of how the organism was spread, she followed the standard operating procedure for working with this pathogen and with the patients. Now, finally, after waiting weeks for the cultures to grow, she had TB isolates from each patient and had just finished recording the results of the sensitivity testing (Table 1). The results were frightening. (Note: these results are fictional, 90% of cases of TB in Canada are Abx sensitive, no increase in Abx resistance has been seen so far).
Transcribed Image Text:Practice Case study p. 224 part: Tuberculosis (TB) in indigenous populations. Lily was a recent science graduate of the University of Alberta and was 11 months into her 12 - month Master of Science in Global Health degree, at Dalhousie University. This relatively new program was created to provide the multidisciplinary training required of scientists working to meet the complex challenges of global public health issues. The University had partnered with the National Collaborating Centre for Indigenous Health (NCCIH) and that was why Lily now found herself doing her Global Health Field Practicum in the Northern Territories, working on a study of drug resistant TB infections among Innuit communities. The different communities included in her research were close to 7000 individuals, with multiple diagnosed cases of TB. And while she was grateful that drug-resistant TB in Canada remained below the global average (Public Health Agency of Canada, 2019), she was cognizant of the possibility that this might not always be the case for Indigenous peoples. In addition, much to our national shame, she knew that the rate of TB among Canadian born Indigenous Peoples was higher than that of Canadian born non-Indigenous people; those worst affected were the Inuit communities, at a shocking 300x higher rate of infection. In fact, incidence rates for 2016 were as follows: 0.6 per 100,000 among Canadian-born, non-Indigenous people. per 100,000 among all First Nations people. 170.1 per 100,000 among Inuit. 2.1 per 100,000 among Métis people. It had been hypothesized that drug resistance was one of the reasons for the increased incidence and mortality rates and the failure of the standard DOT strategy (Directly Observed Treatment), part of the World Health Organization's (WHO) strategy for global eradication of TB. That's where Lily came in: the existence and extent of multi-drug resistant (MDR) TB had not been documented. So, her project was to do just that. Lily was studying two groups of TB patients – one group (group A) included 32 patients who were not responding to DOTS. Her control (group B) consisted of 30 patients who were presumptively diagnosed with TB based on symptoms and a positive sputum smear using acid-fast staining. Group B had just started treatment. Her experimental strategy was quite simple – isolate Mycobacterium tuberculosis from patient sputum samples and determine the resistance of the isolated strains to rifampicin, isoniazid, pyrazinamide, and ethambutol, as well as the antibiotics kanamycin, moxifloxacin and capreomycin. Because of how the organism was spread, she followed the standard operating procedure for working with this pathogen and with the patients. Now, finally, after waiting weeks for the cultures to grow, she had TB isolates from each patient and had just finished recording the results of the sensitivity testing (Table 1). The results were frightening. (Note: these results are fictional, 90% of cases of TB in Canada are Abx sensitive, no increase in Abx resistance has been seen so far).
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