Background/Objectives: Recent investigations point to red foxes (Vulpes vulpes) as a very potent sentinel species for monitoring the dissemination of antimicrobial bacteria in wildlife habitats. Methods: This study investigated antimicrobial resistance in red foxes from 16 hunting grounds (peri-urban and peri-rural) in western Romania, between 2022 and 2024, in order to evaluate the species as “One Health” sentinels at the wildlife–human–animal interface. During this period, 137 bacterial strains previously identified from 216 samples were phenotypically tested using both the Kirby–Bauer disk diffusion method and the Vitek 2 Compact system. Results: Among the Gram-negative isolates, particularly Escherichia coli and Salmonella enterica, notable antimicrobial resistance and multidrug-resistant (MDR) phenotypes were observed, including resistance to third-generation cephalosporins (ceftazidime) and reduced susceptibility to carbapenems. Resistance patterns observed in Proteus spp. largely reflected intrinsic resistance traits. Methicillin-resistant and MDR staphylococci (Staphylococcus aureus, S. pseudintermedius and S. sciuri) were detected in both peri-urban and peri-rural hunting grounds, with higher frequencies observed in peri-rural areas. Although MDR prevalence was slightly higher in peri-urban compared to peri-rural sites, no statistically significant association was identified between area of isolation and antimicrobial resistance or MDR status. Antimicrobial susceptibility results obtained by disk diffusion and the Vitek 2 Compact system showed a high level of concordance for antibiotics tested in common. Conclusions: Overall, these findings support the use of red foxes as effective One Health sentinels for monitoring environmental antimicrobial resistance occurrence across wildlife, domestic animals, and human-impacted habitats.

Antimicrobial resistance (AMR) is an important One Health challenge, yet evidence on resistant Escherichia coli and Salmonella spp. in Romania is dispersed across animal species, food matrices, environmental compartments, and surveillance systems. This comprehensive narrative review synthesizes and critically evaluates evidence across animal–food–environment interfaces and places it in the context of broader European AMR patterns. Particular attention is given to isolate origin, resistance phenotypes, multidrug resistance, major resistance determinants, molecular epidemiology, and the strength of evidence supporting cross-sector connections. Studies most frequently addressed poultry and swine, where resistance to ampicillin, fluoroquinolones, sulfonamides, and tetracyclines was repeatedly reported, together with extended-spectrum cephalosporin resistance, particularly in E. coli. Evidence from cattle, foods of animal origin, companion animals, wildlife, wastewater, and aquatic environments shows that resistant bacteria and antimicrobial resistance genes occur across multiple compartments. Substantial heterogeneity in sampling design, susceptibility testing, and molecular characterization limits direct comparison between studies, while epidemiologically linked investigations and whole-genome sequencing across connected reservoirs remain uncommon. Priorities include more standardized cross-sector surveillance, stronger environmental monitoring, expanded genomic epidemiology, improved data interoperability, and continued antimicrobial stewardship. By integrating fragmented national evidence, this review identifies both well-characterized sectors and interfaces where important evidence gaps remain.