The bacteria also alter macrophage differentiation, migration, and aggregation to induce the formation of granulomas, enigmatic, complex, organized immune structures that can paradoxically promote bacterial growth. Pathogenic mycobacteria infect macrophages and survive in these primary immune defense cells by subverting their endocytic trafficking and microbicidal mechanisms.
TB’s persistence over millennia in the face of these major medical advances underscores the ability of Mycobacterium tuberculosis to evade and exploit host defenses and antibiotics.
TB remains a major cause of death despite a live attenuated vaccine (BCG) for a century and effective antibiotics for 60 years.
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