Over the past decade, the number of carbapenem-resistant Enterobacterales (CRE) infections have continued to steadily increase. While relatively still uncommon in the United States, the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) identified CRE, among other multi-drug resistant organisms (MDROs), as a serious threat to public health on a global scale. This is due in part to adverse patient outcomes, including a high mortality rate (over 40%) in CRE patients with invasive infections.
Any of the clinically relevant species of Enterobacterales are capable of acquiring at least one resistance mechanism to therapeutic options. CRE frequently has multiple resistance mechanisms that render them resistant (from moderate to severe) to most available antimicrobials, including reports of pan-resistant isolates, and these organisms can spread quickly in a healthcare setting. Given the fact that Enterobacterales (e.g., Klebsiella species, Escherichia coli, Enterobacter species) are common causes of community-acquired infections, there is a particular concern that CRE will spread further outside the healthcare setting and into communities.
