The Infinity War: How to Cope with Carbapenem-resistantEnterobacteriaceae

Abstract

Carbapenem-resistant Enterobacteriaceae (CRE) are now spread worldwide. In Korea, the number of CRE isolation is rapidly increasing, and impending endemicity is a concern. To cope well with CRE, thorough infection control, such as active surveillance, early detection, strict contact precaution, cleaning the environment, and antibiotic stewardship is very important. Therapeutic options include polymyxin, tigecycline, fosfomycin or the combination of them with carbapenem, which is currently the mainstay of treatment. In addition, various combination regimens with new carbapenemase inhibitors such as avibactam, vaborbactam, or relebactam, and other classes of antimicrobials such as plazomicin and siderophore cephalosporin are in the process of evaluation.

Control of a hospital-wide outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) using the Israeli national carbapenem-resistant Enterobacteriaceae (CRE) guidelines as a model

“…CRE in Israel has remained well controlled, whereas CRE has become endemic and continues to spread in many other countries. [19][20][21] The key elements leading to the intervention's success were timely identification of CRAB infections and colonization, linked with effective isolation measures. Once identified, carrier patients were flagged, which enabled them to be immediately recognized through the hospital computer systems while they are hospitalized and/or upon transfer or readmission.…”

Modeling of the transmission dynamics of carbapenem resistant Klebsiella pneumoniae in hospitals and design of control strategies

“…Preventing the transmission of and managing infections associated with CRKP is challenging [67][68][69]. In our study, the transmission-controllable area was first proposed to provide criteria for designing potential control measures.…”

Genomic Analysis of two NDM-1 Providencia stuartii Strains Recovered from a Single Patient

“…Carbapenem antibiotics are generally considered to be the last option in the treatment of patients with severe bacterial infections. The recent increase in the rates of carbapenemresistant Enterobacterales (CRE) among healthcare-associated Enterobacterales is a major concern [1][2][3]. Under those circumstances, CRE infections are associated with high mortality due to limited treatment options [1,3].…”

“…The recent increase in the rates of carbapenemresistant Enterobacterales (CRE) among healthcare-associated Enterobacterales is a major concern [1][2][3]. Under those circumstances, CRE infections are associated with high mortality due to limited treatment options [1,3]. In addition, according to the CDC report Antibiotic Resistance Threats in the United States 2019, CRE was also found in the urgent threat category.…”