Format

Send to

Choose Destination
Med Mal Infect. 2017 Feb;47(1):3-10. doi: 10.1016/j.medmal.2016.07.006.

Multidrug and extensively drug-resistant tuberculosis.

Author information

1
Centre d'immunologie et des maladies infectieuses, Sorbonne universités, UPMC université Paris 06, Inserm, UMR 1135, 91, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: thomas.maitre5@gmail.com.
2
Centre d'immunologie et des maladies infectieuses, Sorbonne universités, UPMC université Paris 06, Inserm, UMR 1135, 91, boulevard de l'Hôpital, 75013 Paris, France; Laboratoire de bactériologie-hygiène, centre national de référence des mycobactéries, CHU Pitié-Salpêtrière, AP-HP, 47, boulevard de l'Hôpital, 75013 Paris, France.
3
National reference center for mycobacteria and for mycobacteria resistance to antituberculosis drugs.
4
CNR-MyRMA, CHU Pitié-Salpêtrière, AP-HP, 47, boulevard de l'Hôpital, 75013 Paris, France; CNR-MyRMA, GH Saint-Louis, Lariboisière, F.-Widal, 2, rue Ambroise-Paré, 75010 Paris, France.

Abstract

The emergence of drug-resistant tuberculosis (TB) compromises global tuberculosis control. The incidence of multidrug-resistant strains (MDR) defined as resistant to the two main antituberculosis drugs, rifampicin and isoniazid, was raised in the 1990s. Ten percent of these strains have developed additional resistance to the main second-line antituberculosis drugs: fluoroquinolones and aminoglycosides. These strains are defined as extensively drug-resistant (XDR). The prognosis of MDR-TB and XDR-TB is poor due to limited therapeutic resources. However, many new innovations may lead to a radical change in this field. Genotypic testing is now able to detect drug resistance within a few hours. Genotypic diagnosis of rifampicin resistance is now recommended in France for each new case of TB. The currently recommended treatment for MDR-TB is long (18-24 months) and toxic. It is, however, on the verge of being replaced by a 9-month treatment. New antituberculosis drugs such as bedaquiline and delamanid should also improve the prognosis of MDR-TB and XDR-TB.

KEYWORDS:

Bedaquiline; Bédaquiline; Delamanid; Extensively drug resistance; Multidrug resistance; Multirésistance; Tuberculose; Tuberculosis; Ultrarésistance

PMID:
27637852
DOI:
10.1016/j.medmal.2016.07.006
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center