The purpose of MISTAR is to develop, evaluate, implement and monitor new intervention strategies to control the selection and spread of ARGs and ARB in ´hothouses’ by modulating the microbiota using a One health perspective

Antimicrobial resistance (AMR) has become an endemic and increasing problem, partially under the radar and depriving future generations of effective therapies. A main AMR driver is antimicrobial overuse in humans, animals and environment, facilitating selection and spread of resistant bacteria and genes between the different One Health domains. The goal of MISTAR is to ameliorate the AMR pollution in “hothouses” (hospitals and farms) and thus, to curtail the selection and transmission of AMR within different One Health settings. We will develop and implement intervention strategies to promote microbiota preservation using cutting-edge omics technologies. To reach this goal we will design, implement and quantify (i) the effect of gut microbiota-based interventions (fecal microbiota transplantation and microbiota-based index at point-ofcare) in hospitalized patients to reduce AMR, (ii) the effects of interventions aimed at reducing airborne dustbound pollution and transmission of AMR and (iii) design and develop novel experimental intervention strategies to modulate the microbiota to eradicate AMR. MISTAR delivers important scientific knowledge, technical skills and new interventions to curtail AMR emergence that can be applied in both high- and lowincome countries. A targeted communication plan (scientific, high-quality grey literature and social media) will make the findings of MISTAR accessible to a wide range of stakeholders. Ultimately, the deliverables of this project will guide policymakers to implement novel strategies to control this Global Health challenge.