Changes in the epidemiological situation of multidrug-resistant tuberculosis in Poland in 2018-2022.

Introduction: The presented analysis was conducted against the background of the global pandemic and the Russian-Ukrainian war. The conflict on Poland's eastern border in particular raised concerns that the epidemiological situation in Poland would deteriorate due to the influx of immigrants from countries with a high incidence of MDR-TB and Beijing genotype.

Objectives: To assess the epidemiological situation of MDR-TB in Poland in 2018-2022 and to analyse the prevalence of the Beijing genotype in the Polish and immigrant populations.

Patients And Methods: The study group consisted of 250 patients with MDR-TB, bacteriologically confirmed in 2018-2022. Microbiological, phenotypic, and molecular analysis were used.

Results: There were significant changes in the number of MDR-TB cases, and a significant increase in the registration of this form after the outbreak of the war. One in three patients was infected with pre-XDR strains, and one in four with XDR strains. Forty % of cases were resistant to fluoroquinolones, more often among Polish patients than among immigrants. MDR and MDR in combination with second-line injectable drugs were identified more often among immigrants than among Polish population. The Beijing genotype dominated (n=179 isolates, 71.6%), identified with a similarly high frequency among immigrants and Poles.

Conclusions: The war in Ukraine caused a massive influx of immigrants to Poland, including many infected with MDR and Beijing strains. There is a real risk of an increase in the incidence of MDR-TB in Poland in the future and a risk of TB transmission between immigrants and the native population.