Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Feb 15;215(suppl_1):S28-S36.
doi: 10.1093/infdis/jiw282.

The Epidemiology of Carbapenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace

Latania K Logan  1   2 , Robert A Weinstein  3   2
Affiliations
Review

The Epidemiology of Carbapenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace

Latania K Logan et al. J Infect Dis. .

Abstract

Carbapenem-resistant Enterobacteriaceae (CRE) are a serious public health threat. Infections due to these organisms are associated with significant morbidity and mortality. Mechanisms of drug resistance in gram-negative bacteria (GNB) are numerous; β-lactamase genes carried on mobile genetic elements are a key mechanism for the rapid spread of antibiotic-resistant GNB worldwide. Transmissible carbapenem-resistance in Enterobacteriaceae has been recognized for the last 2 decades, but global dissemination of carbapenemase-producing Enterobacteriaceae (CPE) is a more recent problem that, once initiated, has been occurring at an alarming pace. In this article, we discuss the evolution of CRE, with a focus on the epidemiology of the CPE pandemic; review risk factors for colonization and infection with the most common transmissible CPE worldwide, Klebsiella pneumoniae carbapenemase-producing K. pneumoniae; and present strategies used to halt the striking spread of these deadly pathogens.

Keywords: Enterobacteriaceae infections; adult; antibacterial agents; carbapenemases; carbapenems; child; drug resistance; epidemiology; global health; gram-negative bacteria.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Global distribution of carbapenemases in Enterobacteriaceae, by country and region. Data are adapted from [, , , , , –40]. aKPCs are endemic in some US states; bOXA mainly refers to OXA-48, except in India, where it refers to OXA-181. Abbreviations: IMP, active on imipenem metallo-β-lactamase; KPC, Klebsiella pneumoniae carbapenemase; NDM, New Delhi metallo-β-lactamase; OXA, oxacillinase-type carbapenem-hydrolyzing β-lactamase; VIM, Verona integron-encoded metallo-β-lactamase.
See this image and copyright information in PMC

References

    1. Siegel JD, Rhinehart E, Jackson M, Chiarello L, Health Care Infection Control Practices Advisory Committee. 2007 guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control 2007; 35:S65–164. - PMC - PubMed
    1. Siegel JD, Rhinehart E, Jackson M, Chiarello L, Healthcare Infection Control Practices Advisory Committee. Management of multidrug-resistant organisms in health care settings, 2006. Am J Infect Control 2007; 35:S165–93. - PubMed
    1. Prabaker K, Weinstein RA. Trends in antimicrobial resistance in intensive care units in the United States. Curr Opin Crit Care 2011; 17:472–9. - PubMed
    1. Bush K. Top 10 Beta-lactamase Papers for 2015. Presented at: ASM Microbe 2016. Boston, MA, 18 June 2016.
    1. Jacoby GA, Munoz-Price L. The new β-lactamases. N Engl J Med 2005; 352:380–91. - PubMed

MeSH terms