TB Anywhere, TB Everywhere. The First Case of pre-Extensively Drug Resistant Tuberculosis Treated with BPaL in Italy: Challenges and Opportunities for Transborder Collaboration

Microb Drug Resist. 2025 Jan;31(1):12-15. doi: 10.1089/mdr.2024.0045. Epub 2024 Dec 12.

Abstract

Even if in the past years new effective, safe, and orally administrable drugs are available to create shorter regimens, drug-resistant (DR) tuberculosis (TB) treatment remains a critical issue and a major challenge faced by clinicians worldwide. We present the first case of transborder pulmonary pre-extensively drug-resistant (pre-XDR)-TB treated in Italy with the bedaquiline-pretomanid-linezolid regimen. Diagnosis and treatment were started in Ukraine, and, after a month of treatment, due to the Russo-Ukrainian war, the patient moved to Italy, where the diagnosis was confirmed both by genotypic and phenotypic drug susceptibility tests, and treatment continued. In this short report, we highlight challenges and future opportunities to improve the clinical management of patient with DR-TB.

Keywords: Europe; TB treatment; pre-XDR-TB; transborder.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents* / pharmacology
  • Antitubercular Agents* / therapeutic use
  • Diarylquinolines / pharmacology
  • Diarylquinolines / therapeutic use
  • Drug Therapy, Combination
  • Extensively Drug-Resistant Tuberculosis* / drug therapy
  • Extensively Drug-Resistant Tuberculosis* / microbiology
  • Genotype
  • Humans
  • Italy
  • Linezolid* / pharmacology
  • Linezolid* / therapeutic use
  • Microbial Sensitivity Tests
  • Mycobacterium tuberculosis* / drug effects
  • Nitroimidazoles
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Ukraine

Substances

  • Antitubercular Agents
  • Diarylquinolines
  • Linezolid
  • bedaquiline
  • pretomanid
  • Nitroimidazoles