A well-established antimicrobial resistance (AMR) laboratory-based surveillance (LBS) is of utmost importance in a country like Zambia which bears a significant proportion of the world's communicable disease burden. This study assessed the capacity of laboratories in selected hospitals to conduct AMR surveillance in Zambia. This cross-sectional exploratory study was conducted among eight purposively selected hospitals in Zambia between August 2023 and December 2023. Data were collected using the self-scoring Laboratory Assessment of Antibiotic Resistance Testing Capacity (LAARC) tool. Of the assessed facilities, none had full capacity to conduct AMR surveillance with varying capacities ranging from moderate (63% (5/8)) to low (38% (3/8)). Some of the barriers of AMR-LBS were the lack of an electronic laboratory information system (63% (5/8)) and the lack of locally generated antibiograms (75% (6/8)). Quality control for antimicrobial susceptibility testing (AST), pathogen identification and media preparation had the lowest overall score among all of the facilities with a score of 14%, 20% and 44%, respectively. The highest overall scores were in specimen processing (79%), data management (78%), specimen collection, transport and management (71%), and safety (70%). Most facilities had standard operating procedures in place but lacked specimen-specific standard operating procedures. The absence of laboratories with full capacity to conduct AMR surveillance hinders efforts to combat AMR and further complicates the treatment outcomes of infectious diseases. Establishing and strengthening LBS systems are essential in quantifying the burden of AMR and supporting the development of local antibiograms and treatment guidelines.

中文翻译：

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赞比亚医院抗菌药物耐药性实验室监测能力评估：调查结果和对加强系统的影响


对于赞比亚这样的国家来说，完善的抗菌素耐药性 (AMR) 实验室监测 (LBS) 至关重要，因为赞比亚承担着世界传染病负担的很大一部分。这项研究评估了赞比亚选定医院的实验室进行抗菌素耐药性监测的能力。这项横断面探索性研究是在 2023 年 8 月至 2023 年 12 月期间在赞比亚特意选择的八家医院中进行的。使用自评分实验室抗生素耐药性测试能力评估 (LAARC) 工具收集数据。在接受评估的设施中，没有一个设施完全有能力进行抗菌素耐药性监测，能力范围从中等（63%（5/8））到低（38%（3/8））不等。 AMR-LBS 的一些障碍是缺乏电子实验室信息系统 (63% (5/8)) 和缺乏本地生成的抗菌谱 (75% (6/8))。抗菌药物敏感性测试 (AST)、病原体鉴定和培养基制备的质量控制在所有设施中总体得分最低，分别为 14%、20% 和 44%。总体得分最高的是标本处理（79%）、数据管理（78%）、标本采集、运输和管理（71%）以及安全（70%）。大多数设施都有标准操作程序，但缺乏针对样本的标准操作程序。缺乏完全有能力进行抗菌素耐药性监测的实验室阻碍了抗击抗菌素耐药性的努力，并使传染病的治疗结果进一步复杂化。建立和加强 LBS 系统对于量化 AMR 负担和支持制定当地抗菌谱和治疗指南至关重要。