| Summary: | Livestock, farms, abattoirs, and food supply systems can become the source of foodborne pathogens, including <i>S. aureus</i>, in the absence of monitoring, general hygienic practices, and control. Studies are scarce on reservoirs (hiding places) and routes of entry of <i>S. aureus</i> into the food supply chain in Ethiopia. To fill these gaps, we evaluated the role of cows (milk), meat, equipment, and food handlers on the abundance and AMR of <i>S. aureus</i> in five geographical areas in central Oromia, Ethiopia. We isolated <i>S. aureus</i> from 10 different ecologies per area in 5 areas and tested their sensitivity to 14 antimicrobials of 9 different classes. We ranked the 5 areas and 10 ecologies by computing their multiple AMR index (MARI) at a cut-off value of 0.2 to determine ‘high-risk’ ecologies for AMR. We recorded as MDR if an isolate had resistance to ≥3 antimicrobial classes. We used a circos diagram to analyze if isolates with identical AMR patterns were shared between different ecologies. <i>S. aureus</i> is prevalent in central Oromia (16.1–18.3%), higher in dairy farms than in abattoirs, and varied among 10 ecologies (<i>p</i> < 0.001) but not among 5 areas (<i>p</i> > 0.05). Of the 92 isolates, 94.6% were penicillin-resistant. Their AMR prevalence was above 40% for 9 of 14 antimicrobials. All isolates (100%) had AMR in at least one antimicrobial class (range = 1–9; median = 5), indicating MDR was prevalent. The prevalence of MDR <i>S. aureus</i> varied (<i>p</i> < 0.05) among areas and 10 ecologies; the highest was in slaughter lines. All isolates had a MARI of >0.2, indicating drug overuse, and <i>S. aureus’s</i> AMR burden is high in central Oromia. Dairy farms had higher MARI values (0.44) than abattoirs (0.39). Of 10 ecologies, the highest and lowest MARI values were in the beef supply chain, i.e., slaughter line (0.67) and butcher’s hand (0.25). Of the 68 different AMR patterns by 92 isolates against 14 antimicrobials, 53 patterns (77.9%) were unique to individual isolates, indicating they were phenotypically dissimilar. MDR <i>S. aureus</i> was widespread in central Oromia in dairy and meat supply chains, contaminating milk, meat, equipment, and workers in farm and abattoir settings. In the absence of strict regulations and interventions, MDR <i>S. aureus</i> can be disseminated from these epicenters to the public.
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