Assessment of antimicrobial resistance laboratory- based surveillance capacity of hospitals in Zambia: findings and implications for system strengthening K. Yamba a , J.Y. Chizimu a, * , S. Mudenda b , C. Lukwesa c , R. Chanda d , R. Nakazwe d , B. Simunyola e , M. Shawa f , A.C. Kalungia b , D. Chanda g , T. Mateele h , J. Thapa j , K. Kapolowe g , M.L. Mazaba a , M. Mpundu k , F. Masaninga l , K. Azam m , C. Nakajima j, n, o , Y. Suzuki j, n, o , N.N. Bakyaita l , E. Wesangula m , M. Matu m , R. Chilengi a a Antimicrobial Resistance Coordinating Committee Unit, Zambia National Public Health Institute, Lusaka, Zambia b Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia c Department of Health, Lusaka District Health Office, Lusaka, Zambia d Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka, Zambia e Department of Pharmacy, Ministry of Health, Lusaka, Zambia f Hokudai Center for Zoonosis Control in Zambia, Hokkaido University International Institute for Zoonosis Control, Lusaka, Zambia g Department of Internal Medicine, University Teaching Hospitals, Lusaka, Zambia h Department of Internal Medicine, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia j Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo, Hokkaido, Japan k Action on Antibiotic Resistance (ReAct) Africa, Lusaka, Zambia l Department of Health, World Health Organization, Lusaka, Zambia m Strengthening Pandemic Preparedness, Eastern and Southern Africa Health Community, Arusha, Tanzania n International Collaboration Unit, Hokkaido University International Institute for Zoonosis Control, Sapporo, Hokkaido, Japan o Division of Research Support, Hokkaido University Institute for Vaccine Research and Development, Sapporo, Hokkaido, Japan A RT IC L E I N F O Article history: Received 9 February 2024 Accepted 19 March 2024 Available online 15 April 2024 Keywords: Antimicrobial resistance Antimicrobial stewardship Laboratory capacity Surveillance Zambia S U M M A RY Background: A well-established antimicrobial resistance (AMR) laboratory-based surveil- lance (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 col- lected 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/ * Corresponding author. Address: Antimicrobial Resistance Coordinating Committee Unit, Zambia National Public Health Institute, Stand 1186, Corner of Chaholi & Addis Ababa Roads, Rhoadespark, Lusaka, Zambia. E-mail address: chizimuyjoseph@yahoo.com (J.Y. Chizimu). Available online at www.sciencedirect.com Journal of Hospital Infection journal homepage: www.elsevier.com/locate/jhin https://doi.org/10.1016/j.jhin.2024.03.014 0195-6701/ª 2024 Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY IGO license (http://creativecommons.org/licenses/by/3.0/igo/). Journal of Hospital Infection 148 (2024) 129e137