MULTIDRUG-RESISTANCE TUBERCULOSIS - EPIDE MIOLOGY, TREATMENT, PREVENTION AND DIAGNOSTIC RESEARCHES

The recent augmentation of the prevalence of multidrug resistant (MDR) tuberculosis is related to the high incidence of tuberculosis in HIV infected people, especially in those with low social status and no med ical care; several nosocomial epidemics of MDR tuberculosis were obser ved in American and European institutions where HIV-infected persons w ere hospitalized; these MDR tuberculosis were associated with a high m ortality-rate and frequent nosocomial transmission to immunocompromise d contacts and care workers. The rapid institution of an adequate trea tment with ancient antituberculosis agents (cycloserin, capreomycin, a minoglycosides) and/or new drugs (rifabutine, ofloxacin, sparfloxacin, etc) is necessary to avoid mortality and to diminish transmission. Pr evention of MDR tuberculosis transmission is very important: patient i solation, adequate and prolonged therapy, better detection of resistan ce with gene-amplification methods (PCR) which are under investigation .