Rifampicin-resistant tuberculosis in Spain. Description of a patients cohort.

<bold>Introduction:</bold> We are not aware of clinical and follow-up studies of patients with rifampicin-resistant tuberculosis in Spain. <bold>Aim:</bold> The aim of the study is to determine the characteristics and follow-up of patients with rifampicin-resistant tuberculosis alone (RR-TB) or extended (multidrug-resistant tuberculosis, MDR-TB, and extensively drug-resistant tuberculosis, XDR-TB) in Spain. <bold>Methods:</bold> This is an observational study of a cohort of patients diagnosed and treated in Spain by members of the SEPAR Tuberculosis Research Programme, mainly respiratory and infectious disease specialists, from January 2019 to July 2023. The data were entered, starting in November 2021, in a specific database related to risk factors, diagnosis, and treatment. <bold>Results:</bold> There were 92 patients. The mean age was 37.9±17.9 years, 66 men (71%), foreigners 61 (65.6%), HIV+ 6 (6.5%), with previous TB treatment 23 (24.7%). They came from most of the Spanish Autonomous Communities. They had RR-TB (10), MDR-TB (74), XDR-TB (8). Thirty-seven patients (39.8%) received bedaquiline, 77 (82.8%) linezolid, 76 (81.7%) quinolones, and 26 (28%) delamanid. There was treatment advice from experts in 61 (65.6%). There were difficulties in authorizing medications (mainly bedaquiline) in 42 (45.5%). We have final classification in 68 patients (24 are in treatment, pending of final evaluation): successful treatment in 59 (86.8%), death in 3 (4.4%) (2 due to TB); lost to follow-up in 6 (8.8%). <bold>Conclusions:</bold> A high percentage of patients with rifampicin-resistant tuberculosis in Spain were immigrants, there were difficulties in prescribing bedaquiline, and the preliminary results of treatment were satisfactory. Supported by Grant SEPAR 1100/2020