Sarah is a 55-year-old female who has been admitted to theinfectious disease ward with severe dyspnea, cough and fatigue. Shealso reported a weight loss and numerous episodes of fever over thelast few weeks. Her temperature today is 38.7°C and she had fewepisodes of hemoptysis since this morning. Sarah used to smoke onepack of cigarettes a day for 15 years before she gave it up lastyear after she was diagnosed with Peptic Ulcer Disease.Additionally, Sarah was only discharged from hospital last monthafter she was treated for acute Urinary Tract Infection (UTI).Sarah’s Mantoux tuberculin skin test came back positive and herblood test confirmed that she has got Pulmonary Tuberculosis (PT).She was transferred into a single room for isolation and her doctorinformed her of the diagnosis. Sarah was very anxious and she burstinto tears and said: “Oh my god, I was only discharged fromhospital last month, and now, I have to be admitted again for godknows how long”. Nurse Mary attended to Sarah and entered herroom for assistance, support and reassurance. During her meetingwith her Mary, Sarah wanted to know for how long she would be inthe hospital. She also asked to know which was more dangerous theUTI she had last month or the current PT. Furthermore, Sarahrequested Mary to explain what precautions she needed to take inlight of her medical history and risk factors. Nurse Mary managedto answer all of the questions raised by Sarah. She explained toSarah that her UTI and PT were caused by Escherichia coliand Mycobacterium tuberculosis bacteria respectively. Maryreassured Sarah that luckily, her infection of PT is going to betreated efficiently because Sarah did not delay her coming to thehospital and that she just arrived on time. Mary also told Sarahthat the bacteria that caused the UTI could have a much faster rateof causing complications compared to the bacteria that caused thePT. Sarah’s doctor reviewed her and accordingly commenced her oncombination antibiotic therapy for her PT.

1.Based on the factors that affect microbial growth, classifywhich category does Mycobacterium tuberculosis bacterium belongsto? 20 marks question (I need it in detail please)

2. In the previous case study, explain the reason of why wouldNurse Mary tell Sarah that her PT would be treated efficiently dueto her early arrival to the hospital. (30 mark question)

3. Sarah was commenced on a combination ofantibiotic therapy. Based on the targets of these antimicrobialagents, select three of the most commonly used antibiotics forSarah’s PT and discuss in details how each of these antibioticsworks against the growth of Mycobacterium tuberculosis bacteria.(30 mark)

4. In the case study, Nurse Mary informed Sarah that thebacteria that caused the UTI could have a much faster rate ofcausing complications compared to the bacteria that caused the PT.Based on the two types of bacteria causing UTI and PT and referringto their growth factors, explain Mary’s rational of saying that toSarah.(20marks)