The complex relationship between cyanobacteria and antibiotics/antimicrobial resistance in the environment: An emerging factor in the One Health vision on antimicrobial resistance

In 2015, the World Health Organization (WHO) declared Antimicrobial Resistance (AMR) as one of the most critical health issues. It proposed, with the Food and Agriculture Organization (FAO) and OIE (World Organization for Animal Health), to address this by a One Health approach, recognizing the connection between humans, animals, and environmental health. Currently, a hypothesis is developing that cyanobacteria and cyanotoxins may contribute to AMR in water. Recent research appears to suggest: I) an impact of cyanotoxins on antibiotic-resistance gene transfer between bacteria; ii) a role of cyanobacteria as a reservoir of AMR. Finally, cyanotoxin production appears to be stimulated by cyanobacterial exposure to antibiotics. These findings strengthen the importance of considering the environment in its complexity.