Figure 1.

A framework for antimicrobial resistance in the healthcare network of the 21st century. A multidisciplinary approach for the analysis of AMR in a host metasystem landscape. (A) The current framework to approach health and global health challenges, which includes antimicrobial resistance (AMR) and pandemics [61]. (B) Multidisciplinary approaches to analyzing host and microbe heterogeneity and their interactions in the context of individual human health, which is influenced by intrinsic individual traits (e.g., genetics and physiology) and the exposome (exposure to environment/s, social habits, and contact with abiotic and non-abiotic entities). Individual microbial heterogeneity at sub-specific (gene, plasmid, clone) and supra-specific (microbiome) hierarchical levels is the focus of clinical microbiology and molecular epidemiology; host-microbe interactions and dynamics are analyzed by disease ecology and community ecology. (C) The WHO Health System Building Blocks framework, which was developed to promote a common understanding of the health system [112]. This is relevant for public health investments and results to feed global decision-making. (D) The Bioecological System Model of Human development. It establishes different levels (systems) of exposure to social groups [113,114]. These levels overlap those of microbial exposure. Orange-colored areas represent the influence of time in all systems (human, microbial, individual species, and institutions). Brown arrows represent connections between the various levels. Dotted boxes reflect the central targeted unit, namely humans, in (A,D); human groups in (C); and microbes and hosts in (B).