Deciphering antimicrobial resistance threats at the animal human interface for one health based AMR mitigation

Antimicrobial resistance (AMR) is a major and escalating global public health threat, responsible for substantial morbidity, mortality, and economic loss. The emergence and dissemination of AMR are driven by inappropriate antimicrobial use across human, animal, and agricultural sectors, compounded by inadequate surveillance and fragmented control strategies. A large proportion of priority bacterial pathogens identified by the World Health Organization are linked to animal reservoirs and environmental sources, underscoring the importance of a One Health approach. At the animal–human–environment interface, livestock production systems, companion animals, wildlife, aquaculture, healthcare settings, and environmental reservoirs such as wastewater and surface waters form interconnected pathways that facilitate the bidirectional transmission of resistant bacteria and antimicrobial resistance genes (ARGs). Horizontal gene transfer mediated by mobile genetic elements further accelerates the spread of multidrug- and critically resistant pathogens. Despite growing recognition of these linkages, integrated surveillance of AMR across human, animal, and environmental domains remains limited, particularly in low- and middle-income countries. Recent advances in whole-genome sequencing, metagenomics, and machine learning provide powerful tools for comprehensive AMR surveillance, early detection, and biomarker discovery, including for non-culturable organisms; however, their routine implementation is constrained by infrastructural, financial, and capacity-related challenges. This review synthesizes current evidence on emerging and underexplored AMR threats at the animal–human interface, examines key drivers of resistance transmission, identifies critical knowledge gaps, and highlights innovation priorities for strengthening coordinated One Health surveillance. Enhanced integration of genomic tools with cost-effective diagnostics and harmonized surveillance frameworks is essential to mitigate AMR spread and protect human, animal, and environmental health.