Infection Control and Risk Factors of Carbapenem-Resistant Enterobacteriaceae

Carbapenem-resistant Enterobacteriaceae (CRE) represent a critical challenge to modern healthcare, marked by high morbidity, extended hospital stays and limited therapeutic options. These organisms acquire resistance through production of carbapenemases—enzymes such as KPC, NDM and OXA-48—that inactivate last-resort β-lactam antibiotics. Transmission occurs via direct patient contact, contaminated surfaces or medical devices, and environmental reservoirs. Key risk factors include prior or prolonged antibiotic exposure, intensive care admission, mechanical ventilation, invasive devices and healthcare contact in regions with high CRE prevalence. Infection control combines rigorous hand hygiene, contact precautions, environmental decontamination and antimicrobial stewardship. Active surveillance of high-risk patients on admission, coupled with rapid molecular or culture-based screening, enables early identification of carriers and timely isolation. Predictive models based on patient history and clinical parameters help target interventions. Globally, harmonised surveillance networks and sharing of molecular epidemiology data guide tailored prevention strategies and inform outbreak responses. Continual refinement of screening algorithms, stewardship protocols and novel decolonisation approaches remains essential to curb CRE dissemination and protect vulnerable populations.

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Infection Control and Risk Factors of Carbapenem-Resistant Enterobacteriaceae publication trend

The graph below shows the total number of articles in infection control and risk factors of carbapenem-resistant enterobacteriaceae across all publications each year (not limited to Nature Index journals).

Technical terms

Carbapenem-resistant Enterobacteriaceae (CRE): Enterobacteriaceae family bacteria that produce enzymes disabling carbapenem antibiotics.

Carbapenemase: A β-lactamase enzyme capable of hydrolysing carbapenems and other β-lactam drugs.

Active surveillance: Systematic screening of patients—often by rectal swab—to detect asymptomatic CRE carriage.

Nomogram-based predictive model: A graphical tool combining clinical variables to estimate individual risk of infection.

Antimicrobial stewardship: Coordinated strategies to optimise antibiotic use and minimise resistance development.

References

1. Carbapenem-resistant gram-negative bacterial infection in intensive care unit patients: Antibiotic resistance analysis and predictive model development. Frontiers in Cellular and Infection Microbiology (2023).
2. Active Surveillance of Patients Colonized with CRE: A Single-Center Study Based on a Combined Molecular/Culture Protocol. Antibiotics (2024).
3. Clinical significance and burden of carbapenem-resistant Enterobacterales (CRE) colonization acquisition in hospitalized patients. Antimicrobial Resistance & Infection Control (2023).