A review of rifampicin resistance in mycobacterium tuberculosis: from molecular mechanism to laboratory diagnosis.

Tuberculosis (TB) remains a major global public health challenge, and its control efforts are increasingly complicated by the rising prevalence of drug-resistant TB (DR-TB). Rifampicin (RIF), a cornerstone of first-line anti-TB treatment regimens, plays a pivotal role in TB therapy. The emergence of rifampicin resistance (RR) necessitates significant adjustments in treatment strategies. Therefore, determining Mycobacterium tuberculosis (MTB) resistance to RIF is crucial for optimizing clinical decision-making and improving patient outcomes. This article systematically analyzes current epidemiological trends in rifampicin-resistant TB (RR-TB), explores its molecular mechanisms of resistance in depth, and comprehensively reviews the clinical utility of existing drug-susceptibility testing methods. The aim is to provide a reference for the accurate diagnosis, treatment, and control of RR-TB.