Rifampicin-resistant tuberculosis in Spain
Por:
Garcia-Garcia, Jose-Maria, Rodrigo-Sanz, Teresa, Gullon-Blanco, Jose-Antonio, Garcia, Xavier Casas, Millet, Joan-Pau, Fernandez, Sarai Quiros, Lirola, Miguel-Jose Martinez, Moro, Alberto Mangas, Castellano, Angel Dominguez, Elorza, Enrique Navas, Marcos, Magnolia Nieto, Panisello, Francesc Arasa, Ruiz, Pilar Bermudez, Cabrera, Manuel Garcia, Herrero, Francisco Sanz, Toste, Isabel Suarez, Cerron, Luis Adolfo Urrelo, Guarner, Maria Espiau, Arandes, Antoni Soriano, Guillen, Miguel Arias, Gallardo, Jose-Joaquin Cebrian, Garcia-Fuertes, Julia-Amaranta, Asin, Maria Asuncion Perez-Jacoiste, Gonzalez, Maria Somoza, Gutierrez, Juan-Jose Palacios, Alcaide, Fernando, Blasco, Sofia Samper, Huguet, Eva Tabernero, Cayla, Joan A., Manzano, Juan Ruiz, Luna, Jose Antonio Caminero
Publicada:
23 feb 2026
Resumen:
Objective The aim of the study was to analyse the characteristics of
rifampicin-resistant tuberculosis patients in Spain. Methods This was an
ambispective observational study of a multicentre cohort of patients
diagnosed between January 2019 and July 2023 in most Autonomous
Communities (retrospective period 2019-2020, prospective 2021-2023).
Results 94 patients were included; 83 (88.3%) had pulmonary
tuberculosis. The mean age was 38.00 +/- 17.8 years; 67 (71.3%) were
male, 62 (66.0%) were from countries other than Spain, six (6.4%) were
HIV-infected and 24 (25.5%) had previously treated tuberculosis. Nine
patients had rifampicin-resistant tuberculosis (RR-TB), 75
multidrug-resistant tuberculosis (MDR-TB), nine pre-extensively
drug-resistant tuberculosis (pre-XDR-TB) and one XDR-TB. Treatment
included bedaquiline in 39 (41.5%) patients, linezolid in 87 (92.6%),
fluoroquinolones in 82 (87.2%), clofazimine in 64 (68.0%) and delamanid
in 27 (28.7%). Treatment was supervised by experts in 63 cases (67.0%).
In 43 patients (45.7%), there were difficulties obtaining authorisation
for drug prescription (bedaquiline or delamanid). 21 patients (22.3%)
had difficulties understanding the treatment. The final treatment
outcomes were cured in 60 cases (63.8%), treatment completed in 23
(24.5%), deaths in 3 (3.2%), with 2 due to tuberculosis, loss to
follow-up in five (5.3%) and not evaluated in three (3.2%). No treatment
failures occurred. Successful outcomes were achieved in 83 patients
(88.3%). MDR-TB compared with pre-XDR-TB (OR 8.77, 95% CI 1.42-45.55;
p=0.01) and no treatment comprehension difficulties (OR 10.61, 95% CI
2.78-40.48; p=0.001) were both associated with successful outcomes.
Conclusions Most patients achieved successful outcomes with
individualised regimens guided predominantly by experts. Patients with
pre-XDR-TB and those with comprehension difficulties had significantly
reduced success rates.
Filiaciones:
Spanish Soc Pulmonol & Thorac Surg, TB Res Programme PII TB, Barcelona,
Spain
Hosp Univ San Agustin, Aviles, Spain
Serveis Clin, Barcelona, Spain
Hosp Univ Basurto, Bilbao, Spain
Complejo Hosp Torrecardenas Almeria, Almeria, Spain
Hosp Univ La Paz Cantoblanco Carlos III, Madrid, Spain
Hosp Univ Virgen Macarena, Seville, Spain
Hosp Univ Ramon y Cajal, Madrid, Spain
Hosp Doctor Moliner, Serra, Spain
Hosp Tortosa Verge de la Cinta, Tortosa, Spain
Hosp Reg Univ Malaga, Malaga, Spain
Hosp Univ Doctor Jose Molina Orosa, Arrecife, Spain
Hosp Gen Univ Valencia, Valencia, Spain
Hosp Univ Canarias, San Cristobal La Laguna, Spain
Hosp Univ Vall dHebron, Barcelona, Spain
Hosp Univ Cent Asturias, Oviedo, Spain
Hosp Costa del Sol, Marbella, Spain
Hosp Txagorritxu, Vitoria, Spain
Hosp Univ 12 Octubre, Madrid, Spain
Consorcio Sanitario Terrassa, Terrassa, Spain
Soc Espanolade Enfermedades Infecciosas & Microbio, Madrid, Spain
Hosp Univ Bellvitge, Barcelona, Spain
Inst Aragones Ciencias Salud, Zaragoza, Spain
Hosp Univ Gran Canaria Dr Negrin, Las Palmas Gran Canaria, Spain
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