Colistin Resistance Across the Human–Animal–Environment Interface: A One Health Systematic Review and Meta-analysis

This study aims to assess the global prevalence and genetic epidemiology of colistin resistance across the human, animal, and environmental reservoirs using a One Health framework. Colistin is a "last-resort" antibiotic, and the emergence of plasmid-mediated resistance (mcr genes) threatens its efficacy. Existing surveillance is fragmented; therefore, this review will synthesize data to define the relative contributions of various reservoirs to the global burden of resistance.