_{^{By Dr Tapfumaneyi Mashe}}

Harare, Zimbabwe - Over reliance on antibiotics has also led to the growing silent pandemic of antimicrobial resistance (AMR) over the years. AMR happens when bacteria, viruses, fungi, and parasites evolve and stop responding to antimicrobials over time. The Extended Spectrum Beta-Lactamase Escherichia coli (ESBL Ec) Tricycle study's preliminary findings indicated that multidrug-resistant bacteria were widely distributed in Zimbabwe. Additionally, the 2015 AMR situation analysis in Zimbabwe revealed that only 25% of public health laboratories have the manpower, resources, and supplies required to perform culture and antibiotic susceptibility testing (AST) on human samples. Thus, there is a need for further investment in Zimbabwe's upgraded laboratory diagnostic capabilities.

Directed antimicrobial selection for better patient treatment and outcomes depends on the quick identification (ID) of disease-causing bacteria. In October 2022, Zimbabwe made the Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) technology available for the clinical microbiology laboratory's quick and precise identification of bacteria, mycobacteria, and fungal infections.

A large amount of time can be saved by reliably identifying bacteria, moulds, and yeast on solid media using MALDI-TOF MS. This method of phenotypic identification is quick and less expensive than the norm (after the initial purchase of the instrument). Installation of the equipment was the first step, and then 10 scientists received on-the-job training in MALDI-TOF MS technology. The training was carried out at the National Microbiology Reference Laboratory in Harare, Zimbabwe, with technical support provided by the World Health Organization (WHO) and under the direction of experts from bioMérieux.

“Reducing the time for microbial identification (ID) and antimicrobial susceptibility testing (AST) could reduce the average time to appropriate antimicrobial therapy, resulting in a decrease in mortality, a shorter hospital stay, and lower hospitalization costs,” noted Dr Raiva Simbi, Acting Director of Laboratory Services, Ministry of Health and Child Care.

To increase laboratory capacity for diagnosis, gather information on drug resistance and promote the use of MALDI-TOF MS to support the prudent use of antibiotics, the UK Fleming Fund was established. Zimbabwe benefited from the £4 million provided by the Fund.

The UK’s Development Director for Zimbabwe, Mrs Geraldine O’Callaghan is proud of the MALDI-TOF MS machine installed with the support of the UK’s Fleming Fund will make such a difference in microbial identification. As COVID-19 demonstrated, strong partnerships, better surveillance and early warning systems are key to identifying and isolating future pandemics before they take off and a One Health approach can prepare us for the next pandemic.

“Globally, the UK plays a leading role in building global resilience against threats to human health for a safer and more prosperous world. We take a ‘One Health’ and ‘all hazard's approach that focuses on strong partnerships, multilateral cooperation and leveraging the UK’s science, technology, diplomatic and development expertise,” she said.  

Optimized diagnostics and data-driven solutions play a vital role in preventing the misuse of antibiotics. They enable healthcare providers to select the most effective treatment for a given condition, thereby reducing the risk of antibiotic resistance.