Mechanisms, Significance, Detection and Emerging Therapies for Carbapenem-Resistant Enterobacterales: A Scoping Review

Background

Carbapenems are among the most important broad-spectrum β-lactam antibiotics for the treatment of severe infections caused by multi-drug-resistant Gram-negative bacteria. However, the global emergence and dissemination of carbapenem-resistant Enterobacterales (CRE), particularly carbapenemase-producing Enterobacterales (CPE), have significantly compromised their clinical utility. Resistance is primarily driven by the acquisition of genes encoding carbapenemases, often in combination with porin alterations, efflux pump overexpression and AmpC hyperproduction, resulting in limited treatment options and increased morbidity and mortality.