Year wise comparison of Rifampicin Resistance in Tuberculosis: An Emerging Concern

Background: Rifampicin resistance is a critical marker for multidrug-resistant tuberculosis (MDR-TB). Recently, rifampicin intermediate resistance has emerged as an important early warning indicator for impending drug resistance. Monitoring year-wise trends is essential for programmatic and clinical decision-making.

Objective: To compare the burden of rifampicin-resistant and rifampicin-intermediate tuberculosis cases between the years 2024 and 2025.

Methods: A retrospective comparative analysis of NTEP laboratory data for the years 2024 and 2025 was performed. Total TB cases, rifampicin-resistant cases, and rifampicin-intermediate cases were analyzed and compared using proportions.

Results: Total TB cases increased from 313 in 2024 to 350 in 2025. Rifampicin-resistant cases increased from 2 (0.64%) in 2024 to 9 (2.57%) in 2025, showing a four-fold rise. Rifampicin-intermediate cases increased from 121 (38.66%) in 2024 to 181 (51.71%) in 2025, indicating a substantial rise in intermediate resistance.

Conclusion: A significant increase in both rifampicin resistance and intermediate resistance was observed in 2025. The rising proportion of intermediate resistance may represent a precursor stage to future MDR-TB and warrants urgent attention under NTEP.