Antimicrobial resistance in Escherichia coli at the human–pig interface: A One Health systematic review of genotypic and phenotypic evidence (2019–2024)

This systematic review analyzed whole-genome sequencing data of Escherichia coli from humans and pigs to map antibiotic resistance genes (ARGs) and related phenotypic resistance. Across 13 studies (2019–2024), ampicillin resistance was most common (75% in humans, 100% in pigs), with 80 ARGs identified across 11 antibiotic classes. Frequently reported genes included bla_TEM, sul1/sul2, dfrA17, tet(A/B), and qnrS (notably in pigs). Findings reveal widespread multidrug resistance, geographic variation, and strong links to antibiotic misuse in healthcare and agriculture. The study emphasizes the need for a One Health approach with coordinated surveillance, responsible antibiotic use, and expanded research including metagenomics and environmental monitoring.