OBJECTIVE To explore the risk factors of rifampicin resistance in tuberculosis patients and provide a theoretical basis for further strengthening the prevention and treatment of rifampicin-resistant tuberculosis.

METHODS A total of 1 686 patients diagnosed with tuberculosis based on pathogenic results (positive Mycobacterium tuberculosis culture) and admitted to Hebei Chest Hospital from Jan. 2023 to Dec. 2024 were selected as the study subjects. Based on drug susceptibility test results, they were divided into a rifampicin-resistant group (n=169) and a sensitive group (n=1 517). Logistic regression analysis was used to identify the influencing factors of rifampicin resistance.

RESULTS Statistically significant differences were observed between the resistant and sensitive groups in terms of history of anti-tuberculosis treatment, long-term use of rifampicin, abuse of antibacterial agents during treatment, non-adherence to dosage, medication supervision methods and treatment interruption rates (P < 0.05). Logistic regression analysis revealed that history of anti-tuberculosis treatment (OR=7.326, 95%CI: 3.125 to 9.786), non-adherence to dosage (OR=4.112, 95%CI: 2.674 to 6.155), medication supervision methods (OR=6.452, 95%CI: 3.498 to 9.874), treatment interruption (OR=3.372, 95%CI: 1.458 to 5.899), long-term use of rifampicin (OR=5.426, 95%CI: 1.287 to 6.756) and abuse of antibacterial agents during treatment (OR=2.858, 95%CI: 1.561 to 6.541) were risk factors of rifampicin resistance in tuberculosis patients (P < 0.05).

CONCLUSION In clinical practice, tuberculosis patients with a history of retreatment, non-adherence to dosage, self-medication, treatment interruption, long-term use of rifampicin and abuse of antibacterial agents during treatment, and early, proactive rifampicin resistance screening should be conducted for them.