From chemical mixtures to antibiotic resistance

In real environment, it is unlikely that contaminants exist singly; environmental contamination with chemical mixtures is a norm. However, the impacts of chemical mixtures on environmental quality and ecosystem health have been overlooked in the past. Among the complex interactions between different contaminants, their relationship with the rise of antibiotic resistance (AR) is an emerging environmental concern. In this paper, we review recent progresses on how chemicals or chemical mixtures promote AR. We propose that, through co-selection, agents causing stress to bacteria may induce AR. The mechanisms for chemical mixtures to promote AR are also discussed. We also propose that, mechanistic understanding of co-selection of chemical mixtures for AR should be a future research priority in environmental health research.