Are fermented foods an overlooked reservoir of antimicrobial resistance?

Despite their many cultural, culinary, and health benefits, fermented foods may amplify and disseminate antimicrobial resistance in our food supply. This review summarizes our current understanding of the diversity, distribution, and potential risks of antimicrobial resistance in fermented foods and beverages. Most studies have focused on antibiotic resistance genes (ARGs) in lactic acid bacteria and coagulase-negative Staphylococcus species. Resistance to tetracyclines, penicillins, chloramphenicol, and macrolides is frequently reported. Several studies have demonstrated that ARGs have the potential to be transferred from fermentation microbes to pathogens. Most research has used culture-based or metagenomic surveys or ARGs at the point of production, and few studies have traced the fate of ARGs when ferments are consumed. Cases of humans being directly harmed by resistant microbes in ferments have not been reported, but these foods provide a farm-to-gut pipeline for current and future antimicrobial resistance in our food supply.