The plastisphere as a nexus for antimicrobial resistance: micro(nano)plastics in pathogen colonization, gene transfer, and global health risks

Microplastics (MPs) and nanoplastics (NPs) have emerged as pervasive vectors of antimicrobial resistance (AMR), with the plastisphere being a microbial niche on plastic surfaces acting as a nexus for pathogen colonization, gene transfer, and global health risks. These particles adsorb antibiotics, transport pathogens, and serve as reservoirs for antibiotic resistance genes (ARGs), fostering pathogen-ARG coevolution and horizontal gene transfer (HGT) through biofilm-mediated mechanisms. Despite their recognized role in AMR dissemination, critical gaps persist in understanding how environmental stressors (e.g. salinity, pH) modulate plastisphere dynamics and socioeconomic disparities in exposure. This review synthesizes evidence positioning MPs/NPs as triple threats: microbial habitats, ARG reservoirs, and HGT conduits. We also discuss synergistic interactions of plastisphere biofilms with antibiotics to amplify selective pressures, enabling resistance dissemination across ecosystems and food chains, thereby escalating global health risks. Current research lacks mechanistic insights into real-world plastisphere interactions and longitudinal data linking MPs/NPs to clinical AMR outcomes. We propose actionable One Health strategies including artificial intelligence (AI)-enhanced surveillance, circular economy frameworks, and pathogen-resistant biodegradable polymers to disrupt the plastisphere-driven AMR nexus. Our synthesis underscores the urgency of integrating environmental science, epidemiology, and policy to mitigate risks to ecological and human resilience.