BACKGROUND: Microbiological diagnostics, particularly culture and antimicrobial susceptibility testing, are among the least utilized diagnostic services in Ethiopia. This critical gap is also observed across healthcare systems in many sub-Saharan African countries. However, there is a paucity of data characterizing the limitations and operational challenges in microbiological service delivery. This study examines the gaps identified in public health facilities in Ethiopia.

METHODS: A laboratory-based survey assessing culture and antimicrobial susceptibility testing services was conducted in 13 public hospitals in Addis Ababa between January and March 2024. Data were collected through direct observation, laboratory logbook reviews, and interviews with laboratory personnel, following ethical approval.

RESULTS: There are 13 public hospitals in Addis Ababa serving a population exceeding five million. Of these, eight provide basic bacteriological culture and antimicrobial susceptibility testing services. None of these eight-offer advanced molecular or genotypic testing, nor do they provide anaerobic or fungal culture services. Furthermore, seven of the eight facilities face challenges in delivering comprehensive antimicrobial susceptibility testing, particularly in terms of the range of antibiotics tested. Sustaining uninterrupted services is also a major challenge in these facilities, largely due to financial constraints and weaknesses in the microbiology supply chain management system.

CONCLUSION: In the context of the growing clinical impact of antimicrobial resistance, addressing gaps in microbiological diagnostic services is imperative. The limited range and inconsistency of laboratory services in public health facilities are insufficient to meet current clinical demands and to effectively respond to the increasing threat of drug-resistant pathogens.

KEYWORDS: Microbiology, services, Ethiopia, gaps in services, antimicrobial resistance