Beyond companionship: Current practices and future perspectives in antimicrobial resistance surveillance among companion animals

• Antimicrobial Resistance (AMR) is one the biggest threats of our century, requiring a One Health approach. • While numerous efforts have been made to control and understand AMR diffusion in livestock animals, the role of companion animals (dogs and cats) is still unrecognized. • In this narrative review we summarized the main factors which make companion animals relevant in the global AMR epidemiology, such as increasing presence, close contact with humans, frequent antimicrobial use, and bidirectional transmission. • We recapped scientific evidence reporting multidrug-resistant (MDR) bacteria in dogs and cats, including Highest Priority Pathogens such as Carbanepem-Resistant Enterobacterales (CRE), that are increasingly described also in small animal practice. • We summarized the ongoing national and transnational surveillance systems for AMR in companion animals. • We described, with examples, the main types of surveillance that can be implemented by veterinary healthcare facilities, with strengths and weaknesses for each one. • We highlighted the crucial role of veterinary laboratories for AMR surveillance in pets, through accurate diagnostics, antimicrobial susceptibility testing, strain typing, and use of advanced technologies such as whole-genome sequencing. • Despite the evidence of AMR diffusion and interspecies transmission, current situation is still fragmented, and additional efforts (from both institutional and ground-level) are required to homogenize data collection and surveillance programs.