Background: The rapid rise in antimicrobial resistance (AMR) represents one of the most pressing global health challenges of the 21st century, threatening antibiotic effectiveness, compromising clinical outcomes, and undermining healthcare systems. Understanding how resistant pathogens emerge and spread across human, animal, and environmental sectors is essential for effective global response. Main body: This review evaluates traditional and advanced AMR detection methodologies, including phenotypic assays, molecular diagnostics, whole-genome sequencing (WGS), metagenomics, and biosensor-based technologies. It also highlights the role of bioinformatics tools, surveillance databases, and integrated platforms that support real-time analysis. Genomic surveillance provides unparalleled resolution for characterizing resistance mechanisms, transmission patterns, and evolutionary trajectories of multidrug-resistant organisms. Techniques such as WGS and metagenomics allow timely and precise identification of resistance genes, improving outbreak detection and strengthening antimicrobial stewardship. Despite these advantages, the adoption of genomic surveillance faces barriers in low- and middle-income countries, including high costs, limited infrastructure, insufficient technical expertise, and the lack of standardized data frameworks. Conclusions: Genomic surveillance is a transformative tool for combating AMR and strengthening global health systems. Effective implementation requires sustained investment, capacity-building, coordinated cross-sector collaboration, and commitment to the One Health approach to ensure equitable access and long-term global impact.
Moradkasani et al. (Thu,) studied this question.