title: Carbapenem-resistant Enterobacteriaceae: a menace to our most vulnerable patients.
abstract: The emergence of carbapenem-resistant Enterobacteriaceae (CRE) highlights the importance of effective antibiotics to maintain the safety of our health care system. Clinicians will encounter CRE as a cause of difficult-to-treat and often fatal infections in hospitalized patients. We review the mechanisms of carbapenem resistance, the dissemination and clinical impact of these resistant organisms, and challenges to their detection, treatment, and control.
authors.affiliation: Research Service, Louis Stokes Cleveland Department, of Veterans Affairs Medical Center, Cleveland, OH, USA.
authors.forename: Federico
authors.initials: F
authors.lastname: Perez
authors.forename: David
authors.initials: D
authors.lastname: Van Duin
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015780:Carbapenems / Q000378:metabolism* / Q000627:therapeutic use; D003091:Colistin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000502:physiology; D004755:Enterobacteriaceae; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000635:transmission; D006801:Humans; D007711:Klebsiella pneumoniae; D008911:Minocycline / Q000031:analogs & derivatives / Q000627:therapeutic use; D000078304:Tigecycline; D018440:beta-Lactam Resistance / Q000502:physiology*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D000078304:Tigecycline; D008911:Minocycline; D003091:Colistin
references.citation: Clin Infect Dis. 2012 May;54(9):1314-21
references.pmid: 22492318
references.citation: Infect Control Hosp Epidemiol. 2013 Jan;34(1):1-14
references.pmid: 23221186
references.citation: Lancet Infect Dis. 2011 Nov;11(11):834-44
references.pmid: 21784708
references.citation: Antimicrob Agents Chemother. 2012 Nov;56(11):5744-8
references.pmid: 22926565
references.citation: JAMA. 1998 Oct 14;280(14):1233-7
references.pmid: 9786372
references.citation: Antimicrob Agents Chemother. 2012 Apr;56(4):2108-13
references.pmid: 22252816
references.citation: Burns. 2013 Feb;39(1):174-6
references.pmid: 22694870
references.citation: Am J Infect Control. 2008 Sep;36(7):504-35
references.pmid: 18786461
references.citation: Antimicrob Agents Chemother. 2010 Jan;54(1):526-9
references.pmid: 19901089
references.citation: Antimicrob Agents Chemother. 2011 Jul;55(7):3284-94
references.pmid: 21555763
references.citation: Infect Control Hosp Epidemiol. 2011 Sep;32(9):861-71
references.pmid: 21828966
references.citation: J Antimicrob Chemother. 2010 Aug;65(8):1807-18
references.pmid: 20513702
references.citation: Clin Infect Dis. 2005 Mar 1;40(5):643-54
references.pmid: 15714408
references.citation: Arch Intern Med. 2008 Nov 10;168(20):2254-60
references.pmid: 19001203
references.citation: MMWR Morb Mortal Wkly Rep. 2012 Jun 22;61(24):446-8
references.pmid: 22717513
references.citation: MMWR Morb Mortal Wkly Rep. 2013 Mar 8;62(9):165-70
references.pmid: 23466435
references.citation: Clin Infect Dis. 2011 Nov;53(9):879-84
references.pmid: 21900484
references.citation: Antimicrob Agents Chemother. 2011 Dec;55(12):5893-9
references.pmid: 21968368
references.citation: Lancet Infect Dis. 2011 Mar;11(3):164
references.pmid: 21371654
references.citation: mBio. 2011 Nov 01;2(6):e00204-11
references.pmid: 22045989
references.citation: Clin Microbiol Infect. 2011 Aug;17(8):1135-41
references.pmid: 21635663
references.citation: Diagn Microbiol Infect Dis. 2013 Feb;75(2):115-20
references.pmid: 23290507
references.citation: Clin Infect Dis. 2004 Jan 15;38(2):243-51
references.pmid: 14699457
references.citation: Antimicrob Agents Chemother. 2011 Mar;55(3):1162-72
references.pmid: 21173186
references.citation: Ann Intern Med. 2002 Jun 4;136(11):834-44
references.pmid: 12044132
references.citation: Infect Control Hosp Epidemiol. 2008 Dec;29(12):1107-9
references.pmid: 18973453
references.citation: Clin Microbiol Infect. 2012 Mar;18(3):268-81
references.pmid: 21793988
references.citation: J Antimicrob Chemother. 2003 Mar;51(3):711-4
references.pmid: 12615876
references.citation: Antimicrob Agents Chemother. 2011 Nov;55(11):4943-60
references.pmid: 21859938
references.citation: Infect Control Hosp Epidemiol. 2008 Dec;29(12):1099-106
references.pmid: 18973455
references.citation: Clin Infect Dis. 2012 Oct;55(7):943-50
references.pmid: 22752516
references.citation: Antimicrob Agents Chemother. 2004 Dec;48(12):4793-9
references.pmid: 15561858
references.citation: Clin Infect Dis. 2012 Jun;54(12):1720-6
references.pmid: 22423120
references.citation: Antimicrob Agents Chemother. 2001 Apr;45(4):1151-61
references.pmid: 11257029
references.citation: J Clin Microbiol. 2007 Aug;45(8):2723-5
references.pmid: 17581941
references.citation: Clin Microbiol Rev. 2012 Oct;25(4):682-707
references.pmid: 23034326
references.citation: Antimicrob Agents Chemother. 2011 Jun;55(6):3002-4
references.pmid: 21422205
references.citation: Clin Infect Dis. 2012 Sep;55(6):852-9
references.pmid: 22700827
references.citation: J Antimicrob Chemother. 2003 Sep;52(3):331-44
references.pmid: 12917243
references.citation: Antimicrob Agents Chemother. 2008 Jul;52(7):2680-2
references.pmid: 18426899
references.citation: Am J Infect Control. 2012 Nov;40(9):830-5
references.pmid: 22325727
references.citation: Antimicrob Agents Chemother. 2005 Oct;49(10):4423-4
references.pmid: 16189140
references.citation: Infect Control Hosp Epidemiol. 2010 Dec;31(12):1242-9
references.pmid: 21029005
references.citation: J Antimicrob Chemother. 2008 Mar;61(3):548-53
references.pmid: 18222954
references.citation: J Antimicrob Chemother. 2011 Apr;66(4):952-3
references.pmid: 21393193
references.citation: J Antimicrob Chemother. 2009 Mar;63(3):427-37
references.pmid: 19155227
references.citation: Antimicrob Agents Chemother. 2012 Apr;56(4):1673-9
references.pmid: 22290972
references.citation: Infect Control Hosp Epidemiol. 2010 Oct;31(10):1074-7
references.pmid: 20738186
references.citation: Infect Control Hosp Epidemiol. 2011 Sep;32(9):845-53
references.pmid: 21828964
references.citation: Clin Infect Dis. 2012 Jun;54(12):1699-709
references.pmid: 22467668
references.citation: MMWR Morb Mortal Wkly Rep. 2010 Jun 25;59(24):750
references.pmid: 20577157
references.citation: Int J Antimicrob Agents. 2012 Jan;39(1):52-7
references.pmid: 22055532
references.citation: MMWR Morb Mortal Wkly Rep. 2009 Mar 20;58(10):256-60
references.pmid: 19300408
references.citation: Antimicrob Agents Chemother. 2011 Feb;55(2):593-9
references.pmid: 21115786
references.citation: Sci Transl Med. 2012 Aug 22;4(148):148ra116
references.pmid: 22914622
references.citation: J Antimicrob Chemother. 2011 Sep;66(9):1963-71
references.pmid: 21685488
references.citation: Infect Control Hosp Epidemiol. 2009 Oct;30(10):972-6
references.pmid: 19712030
references.citation: Infect Dis Clin North Am. 2009 Dec;23(4):983-96, ix
references.pmid: 19909894
references.citation: Clin Microbiol Infect. 2011 Jan;17(1):52-6
references.pmid: 20219078
references.citation: Clin Infect Dis. 2012 Dec;55(11):e109-17
references.pmid: 22997214
references.citation: Antimicrob Agents Chemother. 2009 Feb;53(2):818-20
references.pmid: 19029323
references.citation: Diagn Microbiol Infect Dis. 2011 Apr;69(4):357-62
references.pmid: 21396529
references.citation: Clin Microbiol Infect. 2011 Dec;17(12):1798-803
references.pmid: 21595793
references.citation: Antimicrob Agents Chemother. 2009 Dec;53(12):5046-54
references.pmid: 19770275
references.citation: J Clin Microbiol. 2010 Dec;48(12):4417-25
references.pmid: 20881179
references.citation: Ann Intern Med. 2004 Jan 6;140(1):26-32
references.pmid: 14706969