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Role of extended-spectrum β-lactamase (ESBL) genes in the dissemination of β-lactam resistance within aquatic environments: mechanisms, persistence, and one health implications
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This review pulls together existing research showing that rivers, lakes, and other water systems aren't just passive dumping grounds for antibiotic-resistant bacteria, they're active breeding grounds where resistance genes spread and evolve, including within biofilms and on microplastic surfaces. This matters because these drug-resistant bacteria can make their way back to humans, potentially making common infections harder to treat with standard antibiotics.
Antimicrobial resistance of pathogenic bacteria has rapidly increased over the past 20 years, creating a major global health threat. Extended-spectrum β-lactamases (ESBLs) are major drivers of resistance to β-lactam antibiotics, hydrolyzing broad-spectrum cephalosporines and monobactams. ESBL-producing Enterobacteriaceae are widespread across aquatic environments. While previous reviews have broadly described clinical ESBL epidemiology, a comprehensive synthesis explicitly linking aquatic microenvironmental niches, mobile genetic element dynamics, and environmental selection mechanisms remains lacking. This review addresses this gap by critically evaluating how aquatic environments function as active evolutionary reactors rather than mere passive sinks. The dissemination of these ESBL genes depends on conjugative plasmids, insertion sequences, and transposons. Specifically, insertion sequence ISEcp1 mobilizes and enhances the expression of blaCTX-M genes through transposition and strong promoter activity, while IS26 promotes the capture, rearrangement and accumulation of multi-drug resistance determinants within plasmids and transposons. ESBL genes persist in both intracellular and extracellular forms within sediments, biofilms, and microplastic-associated habitats. This review describes the prevalence, mobility, dissemination mechanisms, and environmental-clinical connectivity of ESBL determinants in aquatic systems.
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This review pulls together existing research showing that rivers, lakes, and wastewater aren't just passive dumping grounds for antibiotics and drug-resistant bacteria—they're actually breeding grounds where these germs mix, swap resistance traits, and become even harder to treat, especially when microplastics and other pollutants are present alongside antibiotics. This matters because these "supercharged" resistant bacteria can reach you through drinking water, seafood, or swimming, making common infections harder to cure with standard antibiotics. The authors argue that better wastewater treatment and pollution control are key to slowing this spread before it further thre
The Role of the Environment (Water, Air, Soil) in the Emergence and Dissemination of Antimicrobial Resistance: A One Health Perspective
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This review examines how water, soil, and air act as reservoirs for antibiotic-resistant bacteria, with microplastics highlighted as one of several agents that help spread drug-resistant genes across environments. The findings matter for human health because microplastics can carry antibiotic-resistant bacteria from wastewater and agricultural runoff into water supplies and food systems.
Biofilm formation on microplastics and interactions with antibiotics, antibiotic resistance genes and pathogens in aquatic environment
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This review explains how microplastics in waterways develop bacterial biofilms on their surfaces that can harbor antibiotic-resistant bacteria and help spread antibiotic resistance genes to new environments. This is concerning for human health because these resistant microbes could eventually reach people through drinking water or seafood consumption.
Microplastics in fresh- and wastewater are potential contributors to antibiotic resistance - A minireview
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Researchers reviewed the link between microplastic pollution and the spread of antibiotic resistance in freshwater environments, finding that microplastic surfaces host unique bacterial communities enriched in antibiotic-resistant bacteria and the resistance genes they can share with other microbes. The close packing of bacteria in these plastic-surface biofilms may accelerate the spread of drug-resistant pathogens through drinking water sources, though the full health implications remain poorly understood.
Microplastics: Hidden drivers of antimicrobial resistance in aquatic systems
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This review examines how microplastics in aquatic environments serve as surfaces for biofilm formation, creating what researchers call the 'plastisphere,' which can harbor antibiotic-resistant bacteria and pathogens. Evidence indicates that microplastics facilitate the spread of antimicrobial resistance genes through water systems, potentially affecting both aquatic organisms and human health. The findings underscore microplastics as an overlooked driver of antibiotic resistance in waterways.
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