**5. Conclusions**

Antimicrobial-resistant in *E. coli* has become a serious and complex problem worldwide in clinical treatment as well as in veterinary medicine. *E. coli* is intrinsically vulnerable to all clinically important antimicrobial agents, but it has great potential to accumulate resistance genes, through acquired resistance (HGT).

Acquired resistance plays an essential role in the acquisition of new properties, such as antimicrobial resistance, emphasizing the remarkable adaptive potential of *E. coli*. In addition, among all the MGEs, Transposons and plasmid have a significant role in the spread of antimicrobial resistance with high potential in resistance gene transmission. In *E. coli* plasmid and transposons mediated genes are involved in the spread of quinolone and *Mcr* resistance genes. The epidemiological study of AMR in *E. coli* revealed that *CTX-M* beta-lactamase and ST-131 clone have emerged as the main cause of hospital and community-acquired infections across the globe noteworthy in developing countries. This is being linked with lack of proper prescription of antibiotics and no such strict policy is in place. There are several challenges to implement sustainable and effective AMRs monitoring programs in Africa as well as in Asian countries to encounter the rapid dissemination of AMR. There is a dire need to support and develop antimicrobial policy, standard therapy guidelines for control of AMR in hospitals as well as in the community**.** To promote and regulate the balanced use of medicines and ensure proper patient care at all stages, antibiotics without doctor's prescription should be discouraged and ensure continuous access to essential medicines of guaranteed quality at the hospital and community.
