Tuberculose XDR Problématiques de prise en charge en

Tuberculose XDR
Problématiques de prise en
charge en unité de soins
Matthieu Revest
Maladies Infectieuses
Rennes
Corevih
Rennes, le 3 novembre 2009

COREVIH de Bretagne – 3 novembre 2009 – Tuberculose et VIH
Définitions
Tuberculose multi-resistante (MDR-TB)
Resistance INH et RMP
+/- autres antibiotiques
Tuberculose ultra-resistante (XDR-TB)
MDR-TB
Et resistance aux FQ
Et resistance à un injectable de seconde ligne
(amikacine, kanamycine, et/ou capréomycine)

COREVIH de Bretagne – 3 novembre 2009 – Tuberculose et VIH
No estimate
0–24
50–99
100–299
300 or more
25–49
Estimated new TB cases
per 100 000 population
Rates of new TB cases, 2005

COREVIH de Bretagne – 3 novembre 2009 – Tuberculose et VIH
% MDR TB in Previously Treated Cases
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization
concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent
approximate border lines for which there may not yet be full agreement. © WHO 2006. All rights reserved
Lithuania 53.3%
Kazakhstan 56.4%
Russia (Ivanovo) 58.1%
No estimate
< 6%
6 – 20%
20 – 40%
> 40 %

Countries with XDR-TB Confirmed cases (May 2007)
Czech Republic
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. ©WHO 2005. All rights reserved
Ecuador
Georgia
Argentina
Bangladesh
Germany
Republic of Korea
Armenia
Russian Federation
South Africa
Portugal
Latvia
Mexico
Peru
USA
Brazil
UK
Sweden
Thailand
Chile
Based on information provided to WHO Stop TB Department 1 May 2007
Spain
Islamic Republic of Iran
China, Hong Kong SAR
France
Japan
Norway
Canada
Italy
Netherlands
Estonia
Lithuania
Ireland
Romania
Israel
Azerbaijan
Poland
Slovenia