One carbapenemase, the Klebsiella pneumoniae carbapenemase (KPC), was first identified in the United States in 2001. Many carbapenemase genes are on mobile genetic elements that can be transmitted from one bacterium to another, thereby spreading resistance. The presence of a carbapenemase is usually sufficient to cause carbapenem resistance. Many different mechanisms can lead to carbapenem resistance in Enterobacterales.Ĭarbapenemase-producing CRE make enzymes called carbapenemases that inactivate carbapenems and other β-lactam antibiotics, including penicillins and cephalosporins. How do Enterobacterales become resistant to carbapenems? Some Enterobacterales (e.g., Proteus spp., Morganella spp., Providencia spp.) have intrinsic elevated minimum inhibitory concentrations (MICs) to imipenem and therefore results for meropenem, doripenem, and ertapenem should be used for these organisms to determine if these organisms meet the CRE definition.
The information below is intended for healthcare, laboratory, and public health professionals and provides answers to frequently asked questions about CRE, including types of CRE, identification, and epidemiology and prevention strategies.Įnterobacterales that test resistant to at least one of the carbapenem antibiotics (ertapenem, meropenem, doripenem, or imipenem) or produce a carbapenemase (an enzyme that can make them resistant to carbapenem antibiotics) are called CRE.
Management of Multidrug-Resistant Organisms in Healthcare Settings (2006)Ĭarbapenem-resistant Enterobacterales (CRE) are multidrug-resistant organisms that that can cause serious infections and require interventions in healthcare settings to prevent spread.
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