title: The Epidemiology of Carbapenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace.
abstract: Carbapenem-resistant Enterobacteriaceae (CRE) are a serious public health threat. Infections due to these organisms are associated with significant morbidity and mortality. Mechanisms of drug resistance in gram-negative bacteria (GNB) are numerous; β-lactamase genes carried on mobile genetic elements are a key mechanism for the rapid spread of antibiotic-resistant GNB worldwide. Transmissible carbapenem-resistance in Enterobacteriaceae has been recognized for the last 2 decades, but global dissemination of carbapenemase-producing Enterobacteriaceae (CPE) is a more recent problem that, once initiated, has been occurring at an alarming pace. In this article, we discuss the evolution of CRE, with a focus on the epidemiology of the CPE pandemic; review risk factors for colonization and infection with the most common transmissible CPE worldwide, Klebsiella pneumoniae carbapenemase-producing K. pneumoniae; and present strategies used to halt the striking spread of these deadly pathogens.
authors.affiliation: Section of Pediatric Infectious Diseases, Department of Pediatrics.|Cook County Health and Hospitals System, Chicago, Illinois.
authors.forename: Latania K
authors.initials: LK
authors.lastname: Logan
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Rush Medical College, Rush University Medical Center, and.|Cook County Health and Hospitals System, Chicago, Illinois.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weinstein
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D015780:Carbapenems / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000453:epidemiology*; D019143:Evolution, Molecular; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000235:genetics; D007843:Latin America / Q000453:epidemiology; D011634:Public Health; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Enterobacteriaceae infections; adult; antibacterial agents; carbapenemases; carbapenems; child; drug resistance; epidemiology; global health; gram-negative bacteria