La résistance aux antituberculeux

Anti-tuberculosis drug resistance remains a challenging matter in numerous countries, including countries close to France in Eastern Europa. Consequently, anti-tuberculosis drug resistance surveillance remains essential. Because of the epidemiological importance of multi-drug-resistant, even extensively-drug-resistant tuberculosis (XDR-TB), it is necessary to test not only the first-line drugs but also the new, second-line drugs. Resistances are not transferable but are the consequence of mutations. Resistance mutations are detected by genotypic techniques, which are now available for an increasing number of drugs. The rapidity of the molecular diagnosis is particularly useful for patients with treatment failure, allowing a quick adaptation of the treatment whilst also lowering tuberculosis transmission. However, all resistance mechanisms have not been yet elucidated. The risk of false negative cannot be underestimated with molecular tests and the proportion method must still be performed.