Linking Plastic Pollution and Antimicrobial Resistance: Insights from the Italian Case Study of the TULIP Project

Climate change, plastic pollution, and antimicrobial resistance (AMR) represent interlinked global threats that collectively influence the emergence, persistence, and dissemination of antimicrobial-resistant bacteria in aquatic ecosystems. The EU-funded TULIP project addresses these intertwined challenges in rivers, lakes, and coasts as a single, compounded risk to both human and planetary health (https://tulip-project.eu). Within the TULIP project, the Italian case study integrates strategic sampling methods using artificial plastic substrates and combination of advanced molecular and microbiological techniques to investigate the spread of ARBs and the mechanisms driving antimicrobial resistance in aquatic environments. The study is conducted in the Latium Region (Italy) on two urban-influenced surface waters: the Tiber River, classified as a very large river (RL2) under the Water Framework Directive (2000/60/EC), and its major tributary, the Aniene River. Sampling campaigns were conducted from the winter season (November 2024) through the summer season (June 2025) to capture seasonal variability and to assess the influence of temperature fluctuations on the persistence and dissemination of ARBs in aquatic ecosystems. The outcomes of this study are expected to generate robust insights into the key processes underpinning the emergence, and dissemination of AMR in aquatic environments. In particular, the findings are anticipated to provide scientific evidence on the role of plastic waste as an environmental reservoir and transmission vector for antimicrobial-resistant bacteria and resistance genes, highlighting plastics as a potential route of human exposure to AMR via aquatic pathways. Framed within a Planetary Health perspective, this evidence may support the development of nature-based and low-cost mitigation strategies to reduce the environmental release of AMR and associated resistance genes, with particular relevance for regions lacking conventional wastewater treatment infrastructure.