Are We Measuring or Controlling AMR? Carbapenemases as a One Health Sentinel from Food Systems to Environmental Policy

Antimicrobial resistance (AMR) is driven by the global dissemination of carbapenemase-producing Enterobacterales, compromising last-resort antibiotics and challenging clinical management. Within a One Health framework, carbapenemases represent key molecular markers to investigate transmission dynamics across human, animal, food, and environmental compartments. This presentation integrates current evidence on the occurrence and spread of carbapenemase producers along the food chain, including food-producing animals, retail products, and processing environments. Mechanistic insights into persistence and dissemination remain limited but may involve biofilm formation and horizontal gene transfer. Despite advances in surveillance, critical limitations remain, including inconsistent detection methodologies, underrepresentation of specific resistance mechanisms, and insufficient integration of genomic data for source attribution. Recent environmental monitoring initiatives expand surveillance capacity but frequently lack defined thresholds for intervention and translational pathways to control. By focusing on carbapenemases, this talk evaluates the extent to which current surveillance frameworks inform effective mitigation strategies, emphasizing the need for integrated, risk-based approaches with clear translational impact across the One Health continuum.