The co-occurrence of pesticides and antibiotics in agroecosystems poses a serious threat to soil health and agricultural product safety, emerging as a critical environmental concern. Agroecosystems facilitate the evolution and dissemination of antibiotic resistance bacteria (ARB) and antibiotic resistance genes (ARGs), endangering the environment and public health. Thus, urgent implementation of risk management and control for pesticides, antibiotics, and their associated resistance genes in agroecosystems is imperative. In recent years, a growing number of studies have shown that pesticide pollution can drive the development of pesticide-antibiotic cross-resistance in bacteria, accelerating resistance evolution. This study systematically synthesizes global research on pesticide and antibiotic residues in plant- and animal-derived foods, their migration and accumulation in soil–crop systems, and the mechanistic pathways that facilitate cross-resistance. Key mechanisms include shared enzymatic degradation pathways, activation of efflux pumps, and enhanced horizontal gene transfer, which enable bacteria to acquire resistance to both contaminant types simultaneously. Such interactions not only disrupt soil microbial communities but also facilitate the proliferation and dissemination of ARGs through agricultural products, posing significant public health risks to human health. Finally, we highlight critical knowledge gaps and propose future research priorities, advocating an integrated “One Health” approach to mitigate the synergistic risks of pesticide-antibiotic co-contamination, thereby supporting sustainable agriculture and global food safety.
Li et al. (Mon,) studied this question.