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

Antimicrobial resistance (AMR) is one of the biggest global health threats of our century. While extensive efforts have been made to monitor AMR in food-producing animals, the role of companion animals (dogs and cats) in its emergence and spread has been underestimated. This narrative review describes the current situation of AMR surveillance in companion animals and the role of microbiology laboratories. We outlined key factors impacting the contribution of pets to AMR epidemiology, including their increasing presence in households, close physical proximity to humans, frequent antimicrobial exposure, and the demonstrated bidirectional exchange of resistant bacteria and genes. Evidence of multidrug-resistant (MDR) pathogens of public health concern carried and transmitted by pets is summarized. Surveillance is essential to identify trends, detect emerging resistance, and support stewardship and infection-control measures. However, national and international AMR surveillance systems have only recently begun integrating companion animals. At the setting-level, surveillance programs are uncommon, limited by resource constraints, lack of harmonized guidelines, and dependence on external laboratories. We highlighted with several examples of how microbiological surveillance (active and passive) can provide valuable data. Laboratories play a critical role through accurate diagnostics, antimicrobial susceptibility testing, strain typing, and use of advanced technologies. To effectively address AMR within a One Health (OH) framework, companion animals must be fully included in surveillance systems. Methodological standardization, optimization of laboratory capacity, and integration of surveillance findings into clinical practice are essential.