[Atypical mycobacterial infections]. / Mycobactérioses atypiques.

Infrequent and forgotten before the advent of the acquired immune deficiency syndrome (AIDS), non-tuberculous mycobacterial infections are now often encountered, predominately in patients positive for the human immune deficiency virus (HIV). In non-AIDS patients, Mycobacterium kansasii, M. avium and M. xenopi are the most common causal agents of pulmonary mycobacterial infections. Nodes and skin diseases are less frequent. M. kansasii infections are treated for 12 months with a standard combination of rifampin, isoniazid and ethambutol. The treatment for M. xenopi and M. avium infections have not yet been standardized. The AIDS epidemia has modified the epidemiology of these disease and there has been a 10-fold increase in incidence. Disseminated M. avium infections occur in 15% of patients at end-stage AIDS. This new epidemia has triggered research leading to the discovery of new diagnostic procedure including blood culture media for mycobacteria, polymerase chain reaction (PCR) and new active drugs. New active macrolides such as clarithromycine and azithromycine are active against M. avium and new rifampicin-related drugs such as rifabutine and new quinolones are under investigation.