Abstract
Antimicrobial resistance is a global health crisis that threatens vulnerable populations in low-resource settings. Using the One Health approach, this study investigated AMR in E. coli among children under 5 years old and their surrounding living environments in Lwamondo village, South Africa. From 47 paired stool and soil samples, a total of 117 and 94 E. coli strains were isolated. Isolates were confirmed by PCR, and antimicrobial susceptibility testing was performed against commonly used antibiotics, followed by PCR for β-lactam resistance genes. Phenotypic β-lactam resistance was observed in children under 3 years of age (27-56%). Chloramphenicol was the most frequently detected antibiotic in both stool (41%) and soil (50%) isolates, followed by amoxicillin (27% in stool, 32% in soil). The blaTEM was the most predominant gene, detected in both the stools (36%) and soil (26%) isolates. Phylogenetic analysis revealed that the majority of AMR E. coli belong to Group A. The findings of this study demonstrate the interconnectedness between humans and their surrounding environment, which can both serve as important reservoirs for the transmission of AMR E. coli.