Editing Mycobacterium (section)

=== Virulence factors ===
Mycobacteria have cell walls with [[peptidoglycan]], [[arabinogalactan]], and [[mycolic acid]]; a waxy outer mycomembrane of mycolic acid; and an outermost [[Bacterial capsule|capsule]] of [[glucan]]s and secreted proteins for virulence. It constantly remodels these layers to survive in stressful environments and avoid host immune defenses. This cell wall structure results in colony surfaces resembling fungi, leading to the genus' use of the Greek prefix ''myco-''.<ref>{{cite web |title=Mycobacteria: Health Advisory EPA-822-B-01-007 |url=https://www.epa.gov/sites/default/files/2015-10/documents/mycobacteria-report.pdf |website=epa.gov |publisher=US Environmental Protection Agency (EPA) |access-date=10 March 2023 |page=2 |date=August 1999}}</ref> This unique structure makes [[penicillin]]s ineffective, instead requiring a multi-drug antibiotic treatment of [[isoniazid]] to inhibit mycolic acid synthesis, [[rifampicin]] to interfere with transcription, [[ethambutol]] to hinder arabinogalactan synthesis, and [[pyrazinamide]] to impede [[coenzyme A]] synthesis.<ref name="Dulberger_2020">{{cite journal | vauthors = Dulberger CL, Rubin EJ, Boutte CC | title = The mycobacterial cell envelope - a moving target | journal = Nature Reviews. Microbiology | volume = 18 | issue = 1 | pages = 47–59 | date = January 2020 | pmid = 31728063 | doi = 10.1038/s41579-019-0273-7 | s2cid = 208020338 }}</ref>
{| class="wikitable"
|+''Mycobacterial'' Infection Information
!Organism
!Common Symptoms of Infection
!Known Treatments
!'''Reported Cases (Region, Year)'''
|-
|''M. tuberculosis''
|Fatigue, weight loss, fever, hemoptysis, chest pain.<ref>{{Cite web |date=2022-08-17 |title=Fact Sheets {{!}} General {{!}} Tuberculosis: General Information {{!}} TB {{!}} CDC |url=https://www.cdc.gov/tb/publications/factsheets/general/tb.htm |access-date=2023-04-25 |website=www.cdc.gov |language=en-us}}</ref>
|isoniazid INH, rifampin, pyrazinamide, ethambutol.<ref>{{Cite web| work = American Lung Association|title=Diagnosing and Treating Tuberculosis |url=https://www.lung.org/lung-health-diseases/lung-disease-lookup/tuberculosis/treating-and-managing |access-date=2023-04-25 |language=en}}</ref>
|1.6 Million (Global, 2021)<ref>{{Cite web |title=Global Tuberculosis Report 2022 |url=https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022 |access-date=2023-05-07 |website=www.who.int |language=en}}</ref>
|-
|''M. leprae''
''M. lepromatosis''
|Skin discoloration, nodule development, dry skin, loss of eyebrows and/or eyelashes, numbness, nosebleeds, paralysis, blindness, nerve pain.<ref name="www.cdc.gov_2018">{{Cite web |date=2018-10-22 |title=Signs and Symptoms {{!}} Hansen's Disease (Leprosy) {{!}} CDC |url=https://www.cdc.gov/leprosy/symptoms/index.html |access-date=2023-04-25 |website=www.cdc.gov |language=en-us}}</ref>
|dapson, rifampicin, clofazimine.<ref name="www.cdc.gov_2018" />
|133,802 (Global, 2021)<ref>{{Cite web |title=Global leprosy (Hansen disease) update, 2021: moving towards interruption of transmission |url=https://www.who.int/publications-detail-redirect/who-wer9736-429-450 |access-date=2023-05-07 |website=www.who.int |language=en}}</ref>
|-
|''M. avium'' complex
|Tender skin, development of boils or pus-filled vesicles, fevers, chills, muscle aches.<ref>{{Cite web |date=2021-11-15 |title=Mycobacterium abscessus in Healthcare Settings {{!}} HAI {{!}} CDC |url=https://www.cdc.gov/hai/organisms/mycobacterium.html |access-date=2023-04-27 |website=www.cdc.gov |language=en-us}}</ref>
|clarithromycin, azithromycin, amikacin, cefoxitin, imipenem.<ref>{{cite journal | vauthors = Weng YW, Huang CK, Sy CL, Wu KS, Tsai HC, Lee SS | title = Treatment for Mycobacterium abscessus complex-lung disease | journal = Journal of the Formosan Medical Association = Taiwan Yi Zhi | volume = 119 | pages = S58–S66 | date = June 2020 | pmid = 32527504 | doi = 10.1016/j.jfma.2020.05.028 | series = Consensus Statement of Nontuberculous Mycobacterial Lung Disease in Taiwan | issue = Suppl 1 | s2cid = 219604813 | doi-access = free }}</ref>
|3000 (US, Annual ''estimated'')<ref>{{Citation | vauthors = Scholar E | title=Mycobacterium Avium-Intracellulare Infections |date=2007-01-01 |url=https://www.sciencedirect.com/science/article/pii/B9780080552323608918 |work=xPharm: The Comprehensive Pharmacology Reference |pages=1–5 | veditors = Enna SJ, Bylund DB |access-date=2023-05-07 |place=New York |publisher=Elsevier |language=en |doi=10.1016/b978-008055232-3.60891-8 |isbn=978-0-08-055232-3 |url-access=subscription }}</ref>
|-
|''M. abscessus'' complex
|Coughing, hemoptysis, fever, cavitary lesions.<ref name="Huang_2010">{{cite journal | vauthors = Huang YC, Liu MF, Shen GH, Lin CF, Kao CC, Liu PY, Shi ZY | title = Clinical outcome of Mycobacterium abscessus infection and antimicrobial susceptibility testing | journal = Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi | volume = 43 | issue = 5 | pages = 401–406 | date = October 2010 | pmid = 21075707 | doi = 10.1016/S1684-1182(10)60063-1 }}</ref>
|clarithromycin, amikacin, cefoxitin, imipenem.<ref name="Huang_2010" />
|Unknown
|}