• Microplastics and the Rise of Antibiotic Resistance: An Emerging Challenge in Spreading Infectious Disease, A Review
  • Parvin Mohammadshafiei,1,* Maryam Tahmasbi,2
    1. Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Iran
    2. Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Iran


  • Introduction: The pervasive contamination of global ecosystems with microplastics (MPs, <5mm) and the alarming rise of antibiotic resistance (AR) represent two of the most pressing environmental and public health crises of the 21st century. The World Health Organization (WHO) has declared AR a global threat due to the increasing annual death rate caused by antibiotic-resistant bacteria (ARB). Microplastics (MPs) are widely present in terrestrial and marine environments and pose unique risks to living organisms. They can be absorbed by organisms, enter the food chain, accumulate pollutants on their surfaces, and contribute to antibiotic resistance (AR) in bacteria. Due to their surface properties, MPs act as a platform for the formation of bacterial biofilms and the transfer of antibiotic-resistance genes (ARGs). These polymers support bacteria in acquiring antibiotic resistance by providing a conducive environment for horizontal gene transfer (HGT), including the transfer of ARGs. This review discusses the interplay between MPs and antibiotic resistance, focusing on the interaction between MPs and ARB, and synthesizes current evidence on how MPs act as vectors and amplifiers for antibiotic resistance genes (ARGs) and antibiotic-resistant bacteria (ARB), facilitating their persistence, transport, and dissemination within environments and into human and animal pathogens. Gaining insight into this interaction is crucial for developing strategies to combat the dual threats of MP pollution and the global antibiotic resistance crisis.
  • Methods: This study reviews data accumulated from literature and prestigious case studies related to our subject. The search terms were: "Microplastic," "Antibiotic Resistance," "infectious disease," "Plastisphere," "Biofilm," "Environmental pollution," "Antibiotic resistant bacteria," "Micro and Nano plastics," "Microparticles," "human health threat" using the PubMed, Scopus, ScienceDirect, and Google Scholar databases. Furthermore, manual searches of other relevant journals and keyword searches were performed. We have focused on studies published from 2015 to the present.
  • Results: Current evidence demonstrates that microplastics serve as significant vectors for the propagation of antibiotic resistance among bacterial communities. Experimental data indicate that bacterial populations exposed to microplastics exhibit a marked increase in antibiotic resistance phenotypes relative to controls without microplastic exposure. This phenomenon is primarily attributed to the enhanced formation of biofilms on microplastic surfaces, which facilitate horizontal gene transfer (HGT) of antibiotic resistance genes (ARGs) across diverse bacterial taxa. The impact of microplastics on antibiotic resistance varies according to their physicochemical properties, including polymer type, size, and surface characteristics, with certain polymers such as polystyrene showing a more pronounced effect on resistance amplification. Environmental matrices, notably aquatic and wastewater ecosystems, act as reservoirs where microplastics concentrate both resistant bacteria and ARGs, creating hotspots that accelerate the dissemination of resistance determinants. Furthermore, microplastics contribute to the spread of pathogens, including bacteria, viruses, and parasites, thereby exacerbating the risk of infectious disease transmission. The co-occurrence of pathogens and ARGs on microplastic particles fosters conditions conducive to the emergence and persistence of multidrug-resistant pathogens in natural environments, complicating infection control measures. Collectively, these findings underscore the dual role of microplastics as physical carriers and biological facilitators of antibiotic resistance and infectious agents, highlighting an urgent need for integrated research and policy interventions to mitigate their impact on public health and environmental safety
  • Conclusion: Microplastics serve not only as physical carriers of antibiotic-resistant bacteria and resistance genes but also create favorable environments for horizontal gene transfer, biofilm development, and microbial persistence. This dual function accelerates the dissemination of antimicrobial resistance across natural ecosystems and human-impacted environments. The variability in the effect of different microplastic types and sizes suggests that environmental context and pollutant characteristics influence the magnitude of this problem. Consequently, localized studies focusing on specific ecosystems and plastic pollution profiles are essential for better risk assessment and tailored intervention strategies. Microplastics' role in transporting pathogens over long distances introduces a novel dimension to infectious disease epidemiology. These particles can disseminate multidrug-resistant pathogens beyond traditional boundaries, complicating infection control efforts and increasing the potential for outbreaks. Addressing this emerging threat requires interdisciplinary collaboration among microbiologists, environmental scientists, policymakers, and public health experts. Strategies should include improved wastewater treatment technologies, reduction of plastic pollution, surveillance of microplastic-associated antibiotic resistance, and further research to elucidate mechanistic pathways, quantify risks, and develop effective mitigation approaches
  • Keywords: Microplastics, Antibiotic Resistance, Infectious Disease