Détection de la résistance aux antituberculeux au laboratoire

Despite the introduction 40 years ago of the effective and low-cost treatment of pulmonary tuberculosis combining isoniazid, rifampicin, pyrazinamide and ethambutol, the morbidity and mortality of pulmonary tuberculosis remain considerable worldwide. By 2015, the World Health Organization has estimated a total of 10,4 million new cases of tuberculosis (TB) worldwide. There is a special concern about the increasing number of multidrug-resistant Mycobacterium tuberculosis (MDR-TB), extensively resistant (XDR-TB) strains and some highly resistant strains (TDR-TB). Indeed, the healing rate for MDR-TB and XDR-TB pulmonary tuberculosis is lower than for cases caused by susceptible strains and the mortality rate is higher. In recent years, new medicines and new medical therapies have emerged for all forms of tuberculosis. In parallel, the therapeutic potential of older molecules is re-evaluated. In this short review, we provide an update on methods of detecting the resistance of Mycobacterium tuberculosis to anti-tuberculosis drugs, illustrated by the molecular mechanisms leading to resistance to rifampicin and isoniazid.