What is Koch Bacillus?

Discovered in 1882 by a German doctor and biologist Robert KochKoch’s bacillus (BK). The germ responsible for tuberculosis, one of the global health scourges of our time. “It belongs to the family of mycobacteria of the Mycobacterium tuberculosis complex, explains Professor Roland Brosch, Head of the Integrated Mycobacterial Pathogenomics Unit at the Pasteur Institute. This bacterium is an obligate pathogen, specialized In human infection. Typically, it is the bacteria of the respiratory tract, which Attacks the lungs.” Depending on the location of the infectious focus, three types of tuberculosis are listed.”is the most well-known form Pulmonary infectious tuberculosis Adolescents and adults. Children are more affected by other types of tuberculosis, miliary tuberculosis and meningitis tuberculosis. In the absence of uncontrolled tuberculosis and continuous treatment, the disease can take a severe form. She Spread throughout the bodyCauses extra-pulmonary tuberculosis, such as in the bones (osseous tuberculosis) or in the brain (eg tuberculous encephalitis).“

Koch bacillus is transmitted through the air fine droplets which includes the bacterial load excreted when a An infected person coughs. Transmission is fast. In the absence of treatment, the Pasteur Institute reports that contamination occurs between infected individuals 5 and 15 people average

Bacteria present in France?

In 2020, Santé Public announced France 4,606 cases of tuberculosis

(compared to 5,106 cases in 2019). Three categories of population have been identified as most susceptible. They include homeless people, people born outside France, and people who have been detained. Indeed, this disease is often associated with a deprived context. Considered tuberculosis by WHO except France A global health crisis. “Tuberculosis is one of the world’s leading infectious diseases, causing more than 10 million new cases each year and About 1.4 million deaths people every year”

What symptoms?

Tuberculosis is a complex disease, and its development depends on many factors, especially infection with a viral strain of Koch’s bacillus, but also the immune status and living conditions of the infected person. “Usually, Koch’s bacillus is more easily controlled by healthy people. When an infection occurs, the immune system tries to destroy Koch’s bacillus, often to no avail. Through respiration, the bacillus reaches the pulmonary alveoli., are then ingested by alveolar macrophages. These immune cells try to neutralize it, but BK can defend itself and stay alive. granuloma, A proliferative inflammatory lesion Contains the bacillus, it then forms in the lungs. These granulomas can often contain the infection by immune control of Koch bacillus multiplication, explains Professor Brosch. In other words, when this immune system traps the bacillus in the granuloma, the bacillus remains in a “dormant” or “latent” state. In that situation Deficiency or weakness of the immune system, Koch’s bacillus can multiply and thus cause the development of active tuberculosis. In this case, the granuloma is destroyed, and the bacteria are recirculated in the airways, especially with blood, so one of the characteristic symptoms of the disease: Coughing up blood. Therefore, when coughing occurs, BK is redistributed to others. There is another feature persistent fever.

If tuberculosis is suspected in the presence of suggestive symptoms, biological tests are considered. there Enrichment (analysis of sugar) or Rapid PCR test can be suggested. In addition, there are Immune markers in blood

And blood tests can diagnose possible exposure to the bacillus. On the other hand, in the event of a positive test, biologists do not know whether it is latent or active tuberculosis. Early diagnosis helps prevent transmission to others.

Can we cure these bacteria?

Standard treatment for tuberculosis involves taking 4 First-line anti-tuberculosis antibiotics. “This is a must have treatment managed together In cases of susceptible and non-resistant tuberculosis. That’s about itisoniazid, rifampicin, pyrazinamide and ethambutolThe expert answers. The dose lasts for several months, because in cases of active tuberculosis, the bacterial load in the lungs is very high. Each antibiotic attacks the bacillus with a different target, and so this combination prevents the cochlear bacillus from escaping the treatment by mutating. Otherwise, Koch’s bacillus has the potential to become resistant to treatment.After two months of these 4 antibiotics, two are given for the next 4 months. Hence the standard treatment period 6 months. “If the patient follows his treatment, respects its dosage and its duration, he will recover. more than 98% of patients are treated Using this standard treatment.“

Follow the treatment until the end, even if the symptoms subside

As another purpose: One of the major current problems to be faced is the development of antibiotic resistance, which contributes to the worsening of disease,”A must use Second or third line anti-tuberculosis drugs, with which treatment is longer, more expensive and more difficult. In some cases, we talk about broadly resistant bacteria, when they are resistant to most of the available molecules. Thus, it is very important to continue research to develop new anti-tuberculosis molecules, which can be used against multiple and broadly resistant strains.“

Is an operation necessary?

“Surgery can be considered, however significant risks. It is therefore ideal to know quickly whether a strain is resistant to treatment. Also, the patient must follow the treatment till the end, even if the symptoms subside. Otherwise, this is how the disease reappears and resistant strains develop.”

Vaccination of children with BCG (Basil Calmette and Guerin) before school No longer mandatory since 2007

In France, but recommended for children at high risk of tuberculosis, especially to protect them from severe forms. “Children are susceptible to tuberculosis, and BCG vaccination helps prevent itAvoid meningitis and encephalitis. However, this immune system, which works well in children, declines during adolescence. So are teenagers and adults Active tuberculosis may develop despite vaccination. Tuberculosis remains a major problem in many large cities, including Paris, even if specific contexts such as poverty or war tend to increase the incidence of the disease.Expert explains. Finding a new vaccine that will prevent adolescents and adults from contracting pulmonary tuberculosis is one of our goals, and therefore active research into BCG and other vaccine candidates is ongoing.“