Barriers and pathways to environmental surveillance of antibiotic resistance in middle- andlow-income settings: a qualitative exploratory key expert study

The study explores the practical feasibility of environmental surveillance solutions for antibiotic resistance (ABR) in low- and middle-income countries. It identifies barriers across infrastructural, institutional, and social dimensions, and suggests that these barriers are mostly counterproductive from an ABR management perspective. The research community, international agencies, organizations, and states have key roles and responsibilities in improving the prospects of feasible environmental ABR surveillance in LMI-settings. The study highlights the need for continuous technical and scientific progress in these areas.