The adaptive and further evolutionary responses of Staphylococcus aureus to selection pressure with the antibiotic rifampin have not been explored in detail. We now present a detailed analysis of these systems. The use of rifampin for the chemotherapy of infections caused by S. aureus has resulted in the selection of mutants with alterations within the  subunit of the target enzyme, RNA polymerase. Using a new collection of strains, we have identified numerous novel mutations in the  subunits of both clinical and in vitro-derived resistant strains and established that additional, undefined mechanisms contribute to expression of rifampin resistance in clinical isolates of S. aureus. The fitness costs associated with rifampin resistance genotypes were found to have a significant influence on their clinical prevalence, with the most common clinical genotype (H 481 N, S 529 L) exhibiting no fitness cost in vitro. Intragenic mutations which compensate for the fitness costs associated with rifampin resistance in clinical strains of S. aureus were identified for the first time. Structural explanations for rifampin resistance and the loss of fitness were obtained by molecular modeling of mutated RNA polymerase enzymes.Resistance to antibiotics arising from point mutations in bacterial genes that encode drug targets is a well-recognized phenomenon (38), and expression of these mechanisms often confers a fitness cost that results from the decreased physiological activity of the altered target (1, 37). Nevertheless, increasing evidence obtained both from laboratory and from epidemiological studies indicates that intragenic compensatory mutations often act to maintain the long-term persistence of resistant bacteria by eliminating or reducing the fitness costs associated with the development of target-based resistance (27). Consequently, bacterial products that are the targets of antibiotic action present interesting systems for the study of structure-function relationships from the perspectives of resistance, fitness, and compensatory evolution (15,20). Furthermore, fitness costs and compensatory evolution are factors that can influence the prevalence of specific antibiotic resistance genotypes in the clinical setting (5,19,20,30,43).We have recently explored the genetic and structural basis of mupirocin resistance and fitness in Staphylococcus aureus and related this to the incidence of mupirocin resistant isoleucyltRNA synthetase genotypes arising in the clinic (19,20). A similar opportunity to examine these paradigms in relation to rifampin resistance now arises.Mutations that confer resistance to rifampin (Fig. 1) arise in the  subunit (encoded by rpoB) of the target enzyme RNA polymerase (RNAP) and have been mapped to this location in all bacteria examined so far, including Escherichia coli (21), Mycobacterium tuberculosis (5, 36), and S. aureus (32,43). The fitness burdens and compensatory evolution associated with mutations in rpoB that confer resistance to rifampin have been studied in E. coli (37). However, the ...