Bacteriology testing and antimicrobial resistance detection capacity of national tiered laboratory networks in sub-Saharan Africa: an analysis from 14 countries

作者：Pascale Ondoa, Geetanjali Kapoor, Yewande Alimi, Edwin Shumba, Gilbert Osena, Michael Maina, Deepak Batra, Abdourahmane Sow, Martin Matu, Manuel Moreira, Yenew Kebede, Ramanan Laxminarayan · 发表于：The Lancet Microbe · 年份：2024 · DOI：10.1016/j.lanmic.2024.100976 · 被引用次数：53 · 研究领域：Antibiotic Use and Resistance、Pharmaceutical and Antibiotic Environmental Impacts、Bacterial Identification and Susceptibility Testing

BACKGROUND: Accurate detection of antimicrobial resistance (AMR) depends on adequate laboratory capacity. We aimed to document key weaknesses hindering AMR detection at various tiers of laboratory networks in 14 countries in sub-Saharan Africa, and analyse their significance in AMR surveillance and policies. METHODS: In this analysis, we obtained retrospective data on AMR and antimicrobial consumption from 14 countries participating in the Mapping Antimicrobial Resistance and Antimicrobial Use Partnership between May 1, 2019, and June 30, 2020. We established the number, capacity for AMR detection, and other characteristics from all bacteriology laboratories within the national network from existing national health system compendiums, combined with a self-applied scored survey tool. We calculated AMR detection readiness scores at a facility and country level and analysed the pertinence of national strategies to address system gaps for AMR detection and surveillance. FINDINGS: Of the 53 770 listed laboratories, 675 (1%) were formally assigned to deliver bacterial testing and invited to complete the survey tool. Of the 504 (75%) facilities that returned the completed survey, 393 (78%) reported antimicrobial susceptibility testing (AST) capacity and collectively provided geographical access to less than 50% of the general population in seven countries. Continuous access to water was reported by 347 (88%) laboratories, power sources by 341 (87%) laboratories, and the presence of ...