Assessment of antimicrobial resistance laboratory-based surveillance capacity of hospitals in Zambia: findings and implications for system strengthening

作者：Kaunda Yamba, Joseph Yamweka Chizimu, Steven Mudenda, Chileshe Lukwesa, Rupa Chanda, Ruth Nakazwe, Bwalya Simunyola, Misheck Shawa, Aubrey Chichoni Kalungia, Duncan M Chanda, Tebuho Mateele, Jeewan Thapa, Kenneth Kapolowe, Mazyanga Lucy Mazaba, Mubanga Mpundu, Freddie Masaninga, Kamal Azam, C. Nakajima, Yasuhiko Suzuki, Nathan N. Bakyaita, Evelyn Wesangula, Martin Matu, Roma Chilengi · 发表于：Journal of Hospital Infection · 年份：2024 · DOI：10.1016/j.jhin.2024.03.014 · 被引用次数：22 · 研究领域：Bacterial Identification and Susceptibility Testing、Antibiotic Use and Resistance、Antibiotics Pharmacokinetics and Efficacy

BACKGROUND: 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. METHODS: 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. FINDINGS: 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. CONCLUSION: The absence of laboratories with full capacity to con...