Carbapenem-resistant enterobacteriaceae
Carbapenem-resistant Enterobacteriaceae (CRE) are a group of bacteria that have developed resistance to antibiotics, specifically the class of antibiotics known as carbapenems. These bacteria are part of the larger family of Enterobacteriaceae, which includes many common bacteria such as Escherichia coli (E. coli) and Klebsiella pneumoniae.
Overview
CRE are a significant public health concern due to their high level of resistance to antibiotics. They are often resistant to all available antibiotics and are therefore associated with high mortality rates. Infections caused by CRE are difficult to treat and can lead to severe and often life-threatening infections such as sepsis, pneumonia, and urinary tract infections.
Mechanisms of Resistance
The primary mechanism of resistance in CRE is the production of carbapenemase, an enzyme that breaks down carbapenem antibiotics and renders them ineffective. This resistance can be acquired through mutation or by acquiring resistance genes from other bacteria through horizontal gene transfer.
Prevention and Control
Prevention and control of CRE infections involve a combination of infection control practices, including hand hygiene, use of personal protective equipment, and antibiotic stewardship to prevent the overuse and misuse of antibiotics.
Treatment
Treatment of CRE infections is challenging due to the high level of antibiotic resistance. In some cases, older and more toxic antibiotics may be used. Research is ongoing to develop new antibiotics that can effectively treat CRE infections.
Epidemiology
CRE are a global problem, with cases reported in many countries around the world. They are more common in healthcare settings, particularly in intensive care units and in patients with weakened immune systems or who have been on long courses of antibiotics.
See Also
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Carbapenem-resistant enterobacteriaceae
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Contributors: Prab R. Tumpati, MD