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Paper short abstract

This abstract examines data work underlying antibiotic susceptibility testing in a microbiology lab as sociomaterial practice in a resource-constrained Indian public hospital. It highlights epistemic, infrastructural, and political/moral data work through which evidence is generated and legitimized.

Paper long abstract

Biomedical testing is often framed as a standardized intervention for improving antimicrobial resistance (AMR) diagnostics. However, Science and Technology Studies (STS) scholarship shows tests are not simply implemented but must be enacted through situated practices, infrastructure repair, and political/moral negotiations. In resource-constrained settings, challenges lie not only in performing tests but also in creating and sustaining conditions that make testing possible. Rather than treating antibiotic susceptibility testing (AST) as laboratory protocols, this paper conceptualizes AST as a sociomaterial accomplishment shaping knowledge and clinical futures.

The paper draws on a longitudinal STS-informed study (2021-2025) establishing and operating a culture-based microbiology laboratory in a secondary public hospital in northern India serving migrant and low-income populations. The study draws on documentation of testing practices, laboratory work, record-keeping, and clinician-laboratory-patient interactions to understand work that makes testing possible.

The analysis identifies three interrelated forms of data work: epistemic, involving interpretation and judgment under contamination risk, diagnostic delay, and uneven clinical trust; infrastructural, including maintenance, repair, spatial improvisation, and adaptation to space limitations, unstable electricity, inadequate water supply, equipment breakdowns, and fragile data systems; and political-moral, through which laboratory staff negotiate standards, reporting formats, clinical relevance, patient expectations, and accountability.

The paper argues that AST not only produces diagnostic knowledge but reshapes clinical futures by reorganizing prescribing practices, evidentiary trust, and care pathways. Understanding biomedical testing as sociomaterial practice is essential for reimagining equitable diagnostic futures in resource-limited health systems.

Keywords

Antibiotic susceptibility testing; Antimicrobial resistance; Biomedical testing; Resource-constrained health systems; Science and Technology Studies