Antimicrobial Resistance (AMR) is one of the most daunting challenges to human, animal, and environmental health, and thus should be approached with a One-Health perspective. Increasing focus has been given to the wide-ranging impact AMR will have on our global community. A recent report estimates that by 2050 AMR will not only be dangerous to human health, with annual death tolls reaching 10 million, but may reduce global GDP by as much as 3.8%[1–3]. An alarming increase in AMR to the “last resort” antibiotics used to treat severe infection is being observed, and the World Health Organization (WHO) reported resistance in up to 54% of human pneumonia isolates with an unfortunate lack of new drugs in development [4,5].

According to the Centers for Disease Control & Prevention (CDC) 2019 AMR Threats report, more than 2.8 million antimicrobial-resistant infections occur in the United States each year, 35,000 of which prove fatal [6]. A major concern of the CDC has been in surveilling the emergence and spread of these new forms of resistance, which do not arise only because of medical treatment. While neither antimicrobial use (AMU) in clinical settings nor in agriculture are solely to blame for the increase in the selective pressure for the rise of AMR, efforts must be taken in all sectors to decrease the use of antimicrobials and mitigate the risks associated with AMR.

Researchers and public health officials alike have been monitoring AMR for decades and in response to concerns about this issue, the National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS) was established. The NARMS program is a collaboration of the U.S. Food and Drug Administration (FDA), the CDC, the U.S. Department of Agriculture (USDA), state and local health departments, and universities established to monitor trends in AMR among enteric bacteria from humans, retail meats, and animals in the U.S. [7]. While the U.S. food supply chain is among the safest in the world, foodborne infections are still a concern, and many of these may arise from antimicrobial-resistant bacteria. Hundreds of thousands of Americans still become ill due to resistant Campylobacter or Salmonella each year [8,9], indicating that current surveillance methods are not sufficient for the appropriate application of mitigation strategies, and more efforts are needed to understand the ecology of AMR for effective mitigation interventions to be developed.

The use of antibiotics in animal agriculture is integral to the treatment of and protection against disease. It is imperative that stakeholders in animal agriculture and animal health address the important public health concern of bacterial resistance before antibiotic drugs either become ineffective or are further restricted for use in animals. In fact, according to NIFA’s stakeholder feedback [10], substantial support was demonstrated on the topic areas targeting AMR; furthermore, the development of rapid diagnostic tools, rapid identification tools and techniques, and the role of the microbiome in antimicrobial resistance were specifically stated as areas of interest. Stakeholders also suggested that efforts must be taken to leverage data and knowledge generated from other sources, including Federal activities. 

The CDC and USDA action plans are comprehensive in their approaches to combat antibiotic resistance. The plans call for applied and basic research to:

• enhance surveillance and monitoring of antibiotic resistance,


• better understand the epidemiology and ecology of antibiotic resistance,


• develop new antibiotics and alternatives to antibiotics,


• determine the mechanisms involved in resistance and transmission of resistance,


• determine and/or model patterns and practices that impact the use of antibiotics in animal agriculture


• develop improved diagnostic tests and vaccines.

Described as a ‘wicked’ problem [11], AMR issues will not be solved by any one group or perspective. Antimicrobial resistance is a One-Health [12] phenomenon by definition, and in order to make a difference, all sectors - veterinary medicine, food science, human medicine, basic sciences, farmers, and educators - must be involved. Achieving these goals require interdisciplinary and transdisciplinary collaborations, which are greatly facilitated by multistate collaborations enabled by this project. More specifically, the objectives of this project will include performing research that will allow for the development of practices and recommendations to reduce the development and spread of AMRs. The objectives of this multistate project also aim to track and evaluate the effectiveness of these practices and programs.