A broader perspective on antimicrobial resistance in food chains

Researchers and decision makers repeatedly highlight the need to apply a holistic approach in the fight against antimicrobial resistance (AMR). Nonetheless, current systems for surveillance of AMR in foodborne infections tend to prioritize outbreak-detectable microbial agents. This underestimates foodborne transmission of antimicrobial-resistant organisms that establish colonization or delayed human infection, such as extraintestinal disease, or share a complex epidemiological relationship with the environment. In addition, it underestimates the importance of horizontal gene transmission in various domains. This practice may not be optimal for understanding the evolving dynamics of antimicrobial resistance genes, i.e., the resistome, in food production, or how its contribution to human disease varies across epidemiological and ecological contexts. In this perspective paper, we encourage relevant stakeholders to recognize that transmission of AMR in food chains may have a greater scope and consequences than what is reflected in most surveillance activities and risk assessments. This recognition will have important implications for the further development of integrated One Health surveillance, food safety, and sustainable food systems.