[Multidrug resistant tuberculosis: what is the risk in france?].
A small proportion of bacilli are naturally resistant to each antituberculous drug. Nevertheless the resistance is not expressed and wild isolates almost never show any resistance. Multidrug resistant tuberculosis is defined as resistance to at least isoniazid and rifampicin. Extensively drug resistant tuberculosis (XDR) is also resistant to more than 3 of the 6 classes of second line drugs including fluoroquinolones and aminoglycosides. The multidrug resistance is increasing in Asia and Eastern Europe. For the moment, the phenomena is rare in France (involving 1,1% of tuberculosis cases with 4% of MDR tested XDR). The best preventive measure consists in a proper use of antituberculosis drugs with combined therapy including at least 3 active drugs during the first 2 months. Another challenge is to be aware of the possiblility of resistance and to prevent further transmission to other patients by airborne isolation measures, particularly in immunosuppressed patients.
Bouvet
Elisabeth
E
Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Bichat-Claude-Bernard, Paris. elisabeth.bouvet@bch.aphp.fr
D005602:France / Q000453:epidemiology; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000517:prevention & control