Infections with multidrug-resistant organisms among patients in intensive care units (ICUs) are associated with high mortality. Among multidrug-resistant organisms, carbapenem-resistant Enterobacterales (CRE) harbor important pathogens for healthcare-associated infections, including pneumonia, bacteremia, and urinary tract infections. Risk factors for CRE colonization include underlying comorbid conditions, prior antibiotics exposure, prior use of healthcare facilities, device use, and longer ICU stay. The mortality rate due to invasive CRE infection is 22%–49%, and CRE colonization is associated with an approximately 10-fold increased risk of CRE infection. Infection control measures include hand hygiene, contact precautions, minimizing the use of devices, and environmental control. Additionally, implementing active surveillance of CRE carriage should be considered in ICU settings.
Citations
Citations to this article as recorded by
Bacteriological Profile and Antimicrobial Resistance Patterns in Clinical Isolates From a Tertiary Burns ICU: A Retrospective Comparative Analysis of Carbapenem Resistance and Invasion Neha Nityadarshini, Jaya Biswas, Maneesh Singhal, Shivangi Saha, Tanu Sagar, Kshitija Singh, Sarita Mohapatra, Seema Sood, Bimal Kumar Das, Mukesh Kumar, Ranjna Basyal, Mamta, Benu Dhawan Journal of Burn Care & Research.2026; 47(2): 531. CrossRef
Phenotypic and genotypic characterization of colonization and infection with carbapenem-resistant Enterobacteriaceae: A prospective cohort study in China Yi-Yu Lyu, Yu-Shan Zhang, Jie-Hao Tai, Jun-Li Yan, Wen Huang, Wen-Wen Chu, Min Yang, Qiang Zhou, Yi-Le Wu Journal of Infection.2026; 92(1): 106666. CrossRef
Protocols for decolonisation of carbapenem-resistant Enterobacterales and vancomycin-resistant enterococci: a systematic review and meta-analysis C.E. McCafferty, J.O. Townsend, S.D. Bacchi, S.O. Jensen Journal of Hospital Infection.2026; 170: 184. CrossRef
Infection Prevention and Control in the Intensive Care Unit Brooke K. Decker, Matthew O’Donnell Critical Care Clinics.2026; 42(3): 611. CrossRef
Methicillin-Resistant Staphylococcus aureus (MRSA) and Vancomycin-Resistant Enterococci (VRE) in Nosocomial Infections: A Systematic Review of Resistance, Pathogenesis, and Clinical Management Lucian-Daniel Peptine, Andreea-Eliza Zaharia, Nicoleta-Maricica Maftei, Cosmin-Răducu Răileanu, Elena-Roxana Matache (Vasilache), Alice-Crina Conea, Bianca-Ioana Chesaru, Dana Tutunaru, Oana-Maria Dragostin, Liliana Mititelu-Tarţău, Gabriela Gurău Microorganisms.2026; 14(2): 428. CrossRef
Multidrug-resistant organism co-colonization in patients with discordant direct stool Xpert Carba-R and culture-based carbapenemase-producing Enterobacterales surveillance results Cheon-Hoo Jun, Si-Ho Kim, Hyoung Tae Kim, Yu Mi Wi Journal of Infection and Public Health.2026; 19(5): 103188. CrossRef
Sustainability and Impact of an Antimicrobial Stewardship Program on Broad-Spectrum Antibiotic Consumption in South Korea: A 14-Month Extended Follow-Up Study Tae-Hoon No, Kyeong Min Jo Antibiotics.2026; 15(6): 525. CrossRef
Evaluating the impact of an Antimicrobial Stewardship Programme on antimicrobial resistance, multidrug resistance, and cost of therapy in a private hospital in Malaysia Parwin Kaur Ranjit Singh, Jayah K. Pubalan, Priya Manirajan, Porselvi Arumugam, Palanisamy Sivanandy Discover Public Health.2026;[Epub] CrossRef
Incidence and factors associated with carbapenem-resistant Enterobacterales infection among hospitalized internal medicine patients in Korea: a retrospective observational study Soo-Yeon Park, Hyunjung Kim Journal of Korean Biological Nursing Science.2026; 28(2): 365. CrossRef
Study of carbapenem resistance in patients admitted to MICU in a tertiary care hospital Eby P. Shaji, Jyoti A. Iravane, Mangala S. Harbade, Anil A. Gaikwad International Journal of Research in Medical Sciences.2025; 13(4): 1472. CrossRef
Study on the correlation between carbapenem-resistant Klebsiella pneumoniae infection strains and intestinal colonization strains in intensive care unit of a tertiary hospital in China Li Li, Changlin Yi, Zhenliang Wen, Xiaohong Cai, Peipei Jin Journal of Global Antimicrobial Resistance.2025; 43: 327. CrossRef
Prevalence of carbapenemase genes in Klebsiella pneumoniae and Escherichia coli isolated from intensive care unit patients in Iran: a systematic review (2014–2025) Shahnaz Halimi, Maryam Siroosi Molecular Biology Reports.2025;[Epub] CrossRef
Incidence and risk factors of active carbapenem-resistant enterobacteriaceae surveillance in hematology patients: a propensity score matching study Shaozhen Chen, Jixin Fan, Tingting Xiao, Jinhua Ren, Haojie Zhu, Hui Kong, Dabing Chen, Jingjing Xu, Chenjing Ye, Jiaqi Sun, Caidong Hu, Xiaoyun Zheng, Jing Li, Xiaozhu Yang, Zhizhe Chen, Jianda Hu, Ting Yang Frontiers in Microbiology.2025;[Epub] CrossRef
Distribution and analysis of the resistance profiles of bacteria isolated from blood cultures in the intensive care unit Zeshi Liu, Hehui Cai, Jing Lei, Xue Zhang, Jian Yin, Yanping Zhang, Xueping Yu, Yan Geng Frontiers in Microbiology.2025;[Epub] CrossRef
Effect of Repeated Education on ICU Nurses' Knowledge and Performance in MDRO Infection Control: A Pretest–Posttest Study Kyeongmin Jang Nursing in Critical Care.2025;[Epub] CrossRef
Active screening and molecular epidemiological characteristics of fecal colonization by carbapenem-resistant Enterobacterales in intensive care unit wards of a tertiary hospital in Shanghai, China Hui Zhang, Cong Zhou, Maosuo Xu, Chunmei Shen, Fang Shen, Yong Lin Frontiers in Public Health.2025;[Epub] CrossRef
Carbapenem-Resistant Enterobacterales in Indian ICU Patients: Molecular Insights, Risk Factors, and Clinical Impact Mukesh Kumar Patwa, Sheetal Verma, Vimala Venkatesh, Saurabh Kashyap, Mohit, Zia Arshad Microbial Drug Resistance.2025; 31(9): 279. CrossRef
Diagnostic performance of the direct stool Xpert Carba-R assay in active surveillance of carbapenemase-producing enterobacterales Cheon-Hoo Jun, Si-Ho Kim, Hyoung Tae Kim, Yu Mi Wi Antimicrobial Resistance & Infection Control.2025;[Epub] CrossRef
Spectrum, dose, and duration of antibiotic exposure and risk of intensive care unit–acquired carbapenem-resistant gram-negative bacteria: a prospective cohort study Zhihui Chen, Jing Wu, Xiangru Ye, Zhonghua Li, JingWang, Yueru Tian, Lei Zhou, Jie Ni, Jialin Jin, Wenhong Zhang Annals of Intensive Care.2025; 15(1): 190. CrossRef
Comparison of mortality rates in patients with carbapenem-resistant Enterobacterales bacteremia according to carbapenemase production: a multicenter propensity-score matched study Moon Seong Baek, Jong Ho Kim, Joung Ha Park, Tae Wan Kim, Hae In Jung, Young Suk Kwon Scientific Reports.2024;[Epub] CrossRef
Investigation of Intestinal Colonization and Infection of Carbapenem Resistant Enterobacteriaceae in Intensive Care Unit Patients and Analysis of Influencing Factors 丽红 王 Advances in Clinical Medicine.2024; 14(05): 315. CrossRef
Risk factors of colonization and diversity of clinically significant carbapenemases in gut microbiota of ICU patients: a single-center prospective observational study A.O. Bykov, E.M. Shifman, D.N. Protsenko, S.V. Yakovlev, B.Z. Belotserkovskiy, O.G. Ni, A.N. Kruglov, A.A. Bryleva, M.I. Matyash, E.S. Larin Russian Journal of Anesthesiology and Reanimatology.2024; (5): 41. CrossRef
Occurrence of blaNDM-1, blaNDM-5, blaNDM-7, and blaKPC-2 genes in clinical isolates of enterobacterales with high genetic variability, from colonization and infection in patients with or without COVID-19, from a hospital in Brazil Lamartine Rodrigues Martins, Maria Izabely Silva Pimentel, Érica Maria de Oliveira, Moacir Batista Jucá, Elizabeth Maria Bispo Beltrão, Ana Catarina de Souza Lopes Journal of Applied Microbiology.2024;[Epub] CrossRef
Emergence and expansion of carbapenem resistant enterobacterales in the Western Cape Province, South Africa Kedišaletše Moloto, Mae Newton-Foot, Andrew Whitelaw, Angela Dramowski, Tsegaye Alemeyhu PLOS ONE.2024; 19(8): e0309315. CrossRef
Identification and Preliminary Hierarchisation of Selected Risk Factors for Carbapenemase-Producing Enterobacteriaceae (CPE) Colonisation: A Prospective Study Małgorzata Timler, Wojciech Timler, Ariadna Bednarz, Łukasz Zakonnik, Remigiusz Kozłowski, Dariusz Timler, Michał Marczak International Journal of Environmental Research and Public Health.2023; 20(3): 1960. CrossRef
Epidemiology and prevention of hospital-acquired carbapenem-resistant Enterobacterales infection in hospitalized patients, Northeast Ethiopia Agumas Shibabaw, Zenawork Sahle, Yeshi Metaferia, Asgdew Atlaw, Behailu Adenew, Alemu Gedefie, Mihret Tilahun, Endris Ebrahim, Yeshimebet Kassa, Habtu Debash, Shu-Hua Wang IJID Regions.2023; 7: 77. CrossRef
Gut microbiota alterations in critically Ill patients with carbapenem-resistant Enterobacteriaceae colonization: A clinical analysis Moon Seong Baek, Seungil Kim, Won-Young Kim, Mi-Na Kweon, Jin Won Huh Frontiers in Microbiology.2023;[Epub] CrossRef
ESKAPE and Beyond: The Burden of Coinfections in the COVID-19 Pandemic Miguel Ángel Loyola-Cruz, Luis Uriel Gonzalez-Avila, Arturo Martínez-Trejo, Andres Saldaña-Padilla, Cecilia Hernández-Cortez, Juan Manuel Bello-López, Graciela Castro-Escarpulli Pathogens.2023; 12(5): 743. CrossRef
Aztreonam: clinical and pharmacological characteristics at the present stage D.A. Popov, N.A. Zubareva, A.A. Parshakov Clinical Microbiology and Antimicrobial Chemotherapy.2023; 25(1): 19. CrossRef
Prevalence and risk factors for colonisation and infection with carbapenem-resistant Enterobacterales in intensive care units: A prospective multicentre study Yi-Le Wu, Xiao-Qian Hu, De-Quan Wu, Ruo-Jie Li, Xue-Ping Wang, Jin Zhang, Zhou Liu, Wen-Wen Chu, Xi Zhu, Wen-Hui Zhang, Xue Zhao, Zi-Shu Guan, Yun-Lan Jiang, Jin-Feng Wu, Zhuo Cui, Ju Zhang, Jia Li, Ru-Mei Wang, Shi-Hua Shen, Chao-Yang Cai, Hai-Bin Zhu, Q Intensive and Critical Care Nursing.2023; 79: 103491. CrossRef
Epidemiology of Carbapenem-Resistant Enterobacteriaceae Bacteremia in Gyeonggi Province, Republic of Korea, between 2018 and 2021 Seung Hye Lee, Chan Hee Kim, Hee Young Lee, Kun Hee Park, Su Ha Han Antibiotics.2023; 12(8): 1286. CrossRef
Role of Probiotics in Preventing Carbapenem-Resistant Enterobacteriaceae Colonization in the Intensive Care Unit: Risk Factors and Microbiome Analysis Study Jung-Hwan Lee, Jongbeom Shin, Soo-Hyun Park, Boram Cha, Ji-Taek Hong, Don-Haeng Lee, Kye Sook Kwon Microorganisms.2023; 11(12): 2970. CrossRef
Comparison of the certified Copan eSwab system with commercially available cotton swabs for the detection of multidrug-resistant bacteria in rectal swabs Norman Lippmann, Sebastian Wendt, Catalina-Suzana Stîngu, Johannes Wiegand, Christoph Lübbert American Journal of Infection Control.2022; 50(10): 1145. CrossRef
Clinical Risk Factors and Microbiological and Intestinal Characteristics of Carbapenemase-Producing
Enterobacteriaceae
Colonization and Subsequent Infection
Wenli Yuan, Jiali Xu, Lin Guo, Yonghong Chen, Jinyi Gu, Huan Zhang, Chenghang Yang, Qiuping Yang, Shuwen Deng, Longlong Zhang, Qiongfang Deng, Zi Wang, Bin Ling, Deyao Deng, Arryn Craney, Rafael Vignoli Microbiology Spectrum.2022;[Epub] CrossRef