Whole-genome sequencing identified genetic predictors of rifabutin susceptibility in multidrug-resistant tuberculosis, pointing to a potential path toward more precise drug selection. The study, led from Shenzhen, China, maps bacterial mutations and provides evidence that rifabutin effectiveness may depend on specific genetic signatures. The result is significant for MDR-TB treatment planning because susceptibility testing for secondary drugs can be challenging and varies in coverage across settings. If translated into clinical workflows, bacterial genomics could help tailor regimens more quickly and accurately. For developers of TB diagnostics and therapeutics, the study adds mechanistic support for genotype-informed antibiotic use in resistant disease.