# Antimicrobial Resistance Profiles of Bacteria Isolated from the Animal Health Sector in Zambia (2020–2024): Opportunities to Strengthen Antimicrobial Resistance Surveillance and Stewardship Programs

## TL;DR

This study examines antibiotic resistance in bacteria from Zambia's animal sector, highlighting rising resistance and the need for better surveillance and stewardship.

## Contribution

The study provides new AMR data from Zambia's animal health sector, emphasizing the need for integrated surveillance and stewardship under One Health.

## Key findings

- E. coli showed high resistance to tetracycline and ampicillin but remained susceptible to aztreonam, nitrofurantoin, and imipenem.
- Resistance to amoxicillin/clavulanic acid increased significantly over the study period.
- High levels of multidrug resistance were observed in E. coli and Klebsiella pneumoniae.

## Abstract

Background/Objectives: Antimicrobial resistance (AMR) is a major global health threat that undermines treatment in humans and animals. In Zambia, where livestock production underpins food security and livelihoods, AMR challenges are aggravated by limited surveillance, weak diagnostics, and poor regulatory enforcement, facilitating the spread of resistant pathogens across the human–animal–environment interface. This study aims to analyse AMR patterns of bacterial isolates collected from Zambia’s animal health sector between 2020 and 2024, to generate evidence that informs national AMR surveillance, supports antimicrobial stewardship (AMS) interventions, and strengthens One Health strategies to mitigate the spread of resistant pathogens. Methods: We conducted a retrospective descriptive analysis of previously collected routine laboratory data from five well-established animal health AMR surveillance sentinel sites between January 2020 and December 2024. Data were analysed by year, sample type, and antimicrobial susceptibility testing (AST) profiles using WHONET. Results: A total of 1688 samples were processed, with faecal samples accounting for 87.6%. Animal environmental samples (feed, manure, litter, abattoir/meat processing floor, wall, and equipment surface swabs) (collected from abattoirs, water, and farms) increased significantly over time (p = 0.027). Overall, Escherichia coli (E. coli) (50.4%) and Enterococcus spp. (30%) were the most frequently isolated bacteria. E. coli exhibited high resistance to tetracycline (74%) and ampicillin (72%) but remained susceptible to aztreonam (98%), nitrofurantoin (95%), and imipenem (93%). Enterococcus spp. were susceptible to penicillin (84%) and ampicillin (89%) but showed borderline resistance to vancomycin (53%) and linezolid (50%). Klebsiella spp. demonstrated resistance to ciprofloxacin (52%) and gentamicin (40%), whereas Salmonella spp. remained highly susceptible. Notably, resistance to amoxicillin/clavulanic acid rose sharply from 22.2% to 81.8% (p = 0.027). Across 1416 isolates, high levels of multidrug resistance (MDR) were observed, particularly in E. coli (48.4%) and K. pneumoniae (18.6%), with notable proportions progressing toward possible Extensively Drug-Resistant (XDR) and Pan-Drug-Resistant (PDR) states. Conclusions: The findings of this study reveal rising resistance to commonly used antibiotics in the animal health sector. Despite the lack of molecular analysis, our findings underscore the urgent need for AMS programs and integrated AMR surveillance under Zambia’s One Health strategy.