Communiqué du Groupe de travail de Mycobactériologie Médicale de la Société Française de Microbiologie et du Centre National de référence des Mycobactéries et de la Résistance des mycobactéries aux antituberculeux – 12/04/2023
Les techniques de biologie moléculaire, telles que la PCR, sont de plus en plus utilisées dans le diagnostic des infections bactériennes et de nombreux tests moléculaires sont devenus essentiels dans le diagnostic de la tuberculose et des mycobactérioses.
Néanmoins, ces techniques ne permettent pas de s’affranchir des techniques officiellement recommandées pour le diagnostic de la tuberculose et des mycobactérioses, incluant l’examen direct des prélèvements au microscope et l’isolement des mycobactéries en culture (Référentiel en microbiologie médicale (REMIC) 2022, 7e édition, Société Française de microbiologie).
Dans l’état actuel des connaissances et des techniques disponibles, une stratégie de diagnostic des infections par les mycobactéries reposant uniquement sur la PCR n’est pas recommandée. En effet, utilisés seuls à partir des échantillons, la proportion de « faux négatifs » reste élevée (15 à 20% selon les études ) et des résultats faussement positifs sont également possibles. Aussi, réaliser uniquement une PCR en cas de suspicion de tuberculose ou de mycobactériose représente une perte de chance considérable pour les patients.
Nous rappelons à l’ensemble des biologistes impliqués dans le diagnostic de la tuberculose et des infections à mycobactéries la nécessité de se conformer aux recommandations en vigueur.
Pr Philippe LANOTTE (Groupe de travail de Mycobactériologie Médicale, SFM)
Pr Jérôme ROBERT (Centre National de référence des Mycobactéries et de la Résistance des mycobactéries aux antituberculeux)
Pr Sonia Burrel – Présidente de la Société Française de Microbiologie
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