Carbapenem-resistant Enterobacterales (CRE) is defined by the Centers for Disease Control and Prevention to include Enterbacterales isolates that:8
- test resistant to at least one of the carbapenem antibiotics (ertapenem, meropenem, doripenem, or *imipenem)
OR
- produce a carbapenemase (an enzyme making them resistant to carbapenem antibiotics)
*Note: Some Enterobacterales (e.g., Proteus spp., Morganella spp., Providencia spp.) have intrinsically elevated minimum inhibitory concentrations (MICs) to imipenem and therefore results for meropenem, doripenem, and ertapenem should be used to determine if these organisms meet the CRE definition.8
Risk Factors
Healthy individuals do not usually get infections caused by CRE. CRE most commonly causes infections in people who have chronic medical conditions or have a history of taking certain antibiotics for long periods of time. The most prominent risk factor for contracting CRE in the United States is recent or prolonged exposure to hospitals and other healthcare settings (e.g., long-term care, nursing homes), particularly when the patient's care requires invasive medical devices like urinary catheters, intravenous catheters, or ventilators.
