p.p1 formations of phagosomes. With limited knowledge

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Tuberculosis (TB) is caused by the bacterial species Mycobacterium tuberculosis (2). M tuberculosis is a rod-shaped bacterium 2-4 micrometers in size and is primarily found in the lungs of humans, a well-aerated area, which makes it to be an obligate aerobe. Tuberculosis is also a facultative intracellular parasite, making it capable of living within or outside of the cell with a generally slow generation time of about 15 to 20 hours. One stain used to identify M. tuberculosis is the Ziehl-Neelsen stain, making it an acid-fast bacteria (6). Mycolic acid in the cell wall of M. tuberculosis is made up of peptidoglycan and makes it difficult to stain using traditional stains. Therefore, M tuberculosis is neither Gram-negative or Gram-positive because it doesn’t possess the chemical characteristics of either and generally wouldn’t stain (6). Two media can be used to grow M tuberculosis which are Middlebrook’s medium and Lowenstein-Jensen medium. 
Tuberculosis usually infects the lungs, but can affect any part of the body. All individuals infected with TB don’t become sick, therefore, TB exists in two different forms, latent TB infection (LTBI) and the TB disease (2). Tuberculosis is found worldwide, but the majority of cases are from Asia and Africa. Ninety-five percent of cases and deaths of TB occur in developing countries. India, Indonesia, China, Nigeria, Pakistan, and South Africa are the top countries with the leading cases of TB. This bacterium can affect all age groups, but mostly affects adults. Individuals with HIV are 20 to 30 times more likely to develop TB due to their impaired immune system. Specific populations that TB can affect include, the African-American community, correctional facilities, international travelers, the homeless, and pregnant woman (2). M. tuberculosis lacks classical virulence factors, such as toxins which are the major causes of diseases of other bacterial pathogens (4). Due to the waxy cell wall of Mycobacterium, it aids in survival in the environment and within macrophages. Additional contributions to the pathogenicity of Mycobacterium include its ability to prompt cell-mediated immunity, which is a response involving the activation of phagocytes (3,4). However, survival within macrophages leads to a block in the formations of phagosomes. With limited knowledge of how M. tuberculosis causes disease, its virulence can be measured using mortality and morbidity, with some M. tuberculosis strains being more virulent than others. Tuberculosis has a strong environmental component, such as poor living conditions, exposure intensities, air pollution, smoking, and malnutrition (3). However, how these environmental factors are translated into tuberculosis disease are not well known. Tuberculosis susceptibility also depends on the specific exposure history of a population or person.

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