2013, pp 133-146

Tuberculosis

Abstract

Mycobacterium tuberculosis is an obligate human pathogen of immense importance, infecting up to one third of the human population and causing 1.4 million deaths per year. Despite a long-established vaccine and initially effective antibiotics, M. tuberculosis continues to be a scourge of mankind through a combination of factors: related to the organism, host, their interaction, co-infections such as with HIV, and societal issues. The hallmark of M. tuberculosis as a pathogen is its intracellular growth and ability to evade killing by macrophages, including latent infection for many years. Here we consider distinctive characteristics of the organism, pathogenesis, epidemiology, clinical syndrome, diagnosis, treatment, and prevention of tuberculosis. Pressing challenges include combating drug resistance, designing better vaccines, improved diagnostics, and simplified treatment regimes. Molecular techniques are increasingly being transferred from bench to bedside and the coordinated efforts of microbiologists, immunologists, epidemiologists, clinicians, and policy-makers are required to turn the tide against tuberculosis.