[Multidrug-resistant tuberculosis].

Abstract

The quality of diagnosis and therapeutic management affects the frequency of multiresistant tuberculosis observed in a given country. In 1991, physicians in the United States were faced with a large number of cases of multiresistant tuberculosis in patients with acquired immune deficiency syndrome, leading to international public health measures designed to prevent the development of resistant strains. At the present time there are only a limited number of resistant strains in France. Continuous surveillance of multiresistant strains by the 33 University Hospitals in Paris and 300 bacteriology laboratories throughout France has shown that the rate of multiresistance is 0.7%. Six of the 8 cases of primary resistance observed in Paris from 1992 to 1994 were associated with human immunodeficiency virus infection. Approximately half of the cases with secondary multiresistance occurred in subjects born outside France. Patients with multiresistant tuberculosis must be placed in strict isolation and given long-term treatment combining antibiotics and toxic products requiring careful handling in a specialized unit.