Shiga toxin-producing Escherichia coli (STEC) is a major zoonotic foodborne pathogen associated with severe human illnesses, including hemorrhagic colitis and hemolytic uremic syndrome. While ruminants are traditionally recognized as the primary reservoirs, increasing evidence suggests that poultry production systems may also contribute to the dissemination of pathogenic and antimicrobial-resistant E. coli through the food chain. However, the extent of this contribution and its relevance to human infection remain incompletely understood. This review provides a critical synthesis of the virulence mechanisms, epidemiology, and antimicrobial resistance (AMR) of E. coli, with particular emphasis on STEC in poultry production systems. Key virulence determinants, including Shiga toxins (Stx1 and Stx2), the locus of enterocyte effacement, and plasmid-encoded factors, are discussed in relation to their roles in host colonization and disease progression. Transmission pathways within poultry production and processing environments are examined, highlighting critical points of contamination from farm to consumer. The increasing prevalence of multidrug-resistant and extended-spectrum β-lactamase-producing E. coli in poultry underscores significant public health concerns. However, variability in epidemiological data and limitations in current surveillance systems complicate the interpretation of transmission dynamics. Current and emerging control strategies, including biosecurity measures, alternative antimicrobial interventions, and processing hygiene, are evaluated alongside their practical limitations under commercial conditions. Overall, this review identifies key knowledge gaps and emphasizes the need for integrated, evidence-based approaches within a One Health framework to better define zoonotic risks and develop sustainable control strategies.
Fatima et al. (Mon,) studied this question.