Antimicrobial resistance cannot be characterised from any single hospital or laboratory, and most countries have converged on a common architecture in which many clinical microbiology laboratories submit standardised susceptibility data to a national coordinating centre supported by a reference laboratory. This narrative review examines what such networks have achieved as of the 2020 reporting year, drawing on institutional reporting from the World Health Organization, the European Centre for Disease Prevention and Control, and the United States Centers for Disease Control and Prevention, alongside the applied literature on diagnostic infrastructure, facility engineering, procurement and logistics, laboratory informatics, data protection, occupational safety, medicine quality assurance, workforce competence, and monitoring across the animal, food, and environmental sectors. The advances of the preceding five years have been largely infrastructural rather than microbiological. A global data standard has reached working scale, the movement of data rather than bench competence has emerged as the binding constraint on national reporting, external quality assessment has become the mechanism that licenses aggregation rather than an optional mark of individual laboratory quality, and molecular and genomic methods have attached to the reference tier without displacing phenotypic testing at contributing sites. Reading that record together with evidence from the enabling domains that determine whether a laboratory can participate at all, which is the contribution attempted here, indicates that the principal constraints on these networks are engineering, logistical, financial, and organisational rather than technical, and that their residual methodological weaknesses concern representativeness, denominators, and data use rather than data volume. The review argues that surveillance programmes should be budgeted and evaluated as distributed infrastructure systems, and identifies the specific components on which that framing places priority.