Antibiotic Resistance Genes in Aquatic Environments: Sources, Transmission, and Influencing Factors from a One Health Perspective

Antibiotic resistance genes (ARGs) are emerging environmental contaminants that pose significant threats to public health due to their persistence, migration and dissemination in aquatic environments. This review systematically summarized the mechanisms of ARG resistance, their spread in human and animal populations, and primary input pathways into water bodies, including medical and aquaculture wastewater. Key environmental drivers of ARG evolution and dissemination are analyzed, encompassing selective pressures from antibiotics and heavy metals, horizontal gene transfer mediated by mobile genetic elements, and physicochemical factors such as dissolved oxygen, pH, and nutrient levels. Finally, current research gaps are highlighted, and future directions are proposed for monitoring and controlling ARG transmission, and assessing associated health risks under the One Health framework. This review provides a scientific basis for understanding the ARG crisis in aquatic environments and guiding integrated management strategies.