L’essor de la tuberculose pharmacorésistante

BALTIMORE – La tuberculose, l’une des maladies infectieuses les plus mortelles, fait un retour en force, notamment en Afrique. La tuberculose ultra-résistante (XDR-TB) est une souche de tuberculose difficile à traiter qui attaque là où les systèmes de santé sont traditionnellement faibles, surtout dans les zones très touchées par le VIH. L’échec à contenir les épidémies locales, à développer des outils et des stratégies pour identifier et traiter la XDR-TB, et à investir dans des améliorations sur le plus long terme du contrôle de la tuberculose pourrait transformer nos médicaments miracles contre la tuberculose en tirs à blanc.

Le développement de la chimiothérapie pour traiter la tuberculose, des années 1940 aux années 1970, a transformé l’ancienne “peste blanche” en maladie possible à soigner. Mais le traitement de la tuberculose est menacé par le spectre de la résistance aux médicaments depuis le début de l’ère des antibiotiques. Il y a quinze ans, une épidémie de tuberculose multi-résistante (MDR-TB) à New York a failli déclencher une panique, avant qu’une injection massive de fonds dans l’infrastructure de santé publique ne renverse la vapeur aux États-Unis, et que l’intérêt du public ne décline. Pourtant, le problème de la résistance aux médicaments a persisté, et les tentatives de la contenir au niveau mondial n’ont pas suffi.

Bienvenue dans l’univers de la XDR-TB. L’Organisation mondiale de la santé estime qu’il y a eu 425 000 nouveaux cas de MDR-TB en 2004, dont plus de 60 % en Chine, en Inde et en Russie. Mais c’est une épidémie massive de XDR-TB chez des patients infectés par le VIH au KwaZulu-Natal, en Afrique du Sud, qui a tourné tous les regards du monde vers le problème des organismes ultra-résistants.

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