A One Health Perspective on Bacterial Extracellular Vesicles as Mediators of Antimicrobial Resistance Spread

Abstract Antimicrobial resistance (AMR) is a global health threat requiring a One Health approach across human, animal, and environmental sectors. Bacterial extracellular vesicles (BEVs), membrane-bound particles secreted by bacteria, have emerged as potential vectors of antibiotic resistance and mediators of horizontal gene transfer. Found across clinical, agricultural, and natural environments, BEVs carry resistance genes, mobile genetic elements, and virulence factors. They protect genetic cargo, function without direct cell contact, and can cross ecological boundaries more easily than whole bacteria. This review synthesises current knowledge on BEVs in AMR transmission, highlights their cross-sector potential, and identifies key research gaps. Recognising their role is essential for improving AMR surveillance and informing future mitigation strategies.