What are CRE?
Carbapenem-resistant Enterobacteriacae (CRE) [also known as carbapenemase-producing Enterobacteriacae (CPE)] is the collective name for a family of microorganisms that have high levels of resistance to antibiotics. Two of the most common bacteria in the Enterobacteriacae family that can develop resistance to carbapenem antibiotics family include Escherichia coli (E. coli), and species of Klebsiella. Others include species of Serratia, Enterobacter, Salmonella and Citrobacter.
CRE are sometimes referred to by the names of the enzymes – the carbapenemases – that break down carbapenem antibiotics such as imipenem, ertapenem, meropenem and doripenem. Three well-known CRE include KPC (Klebsiella pneumoniae carbapenemase), NDM (New Delhi Metallo-beta-lactamase) and OXA-48. CRE are resistant to many antibiotics, with some being resistant to all or almost all antibiotics. As a result, infections are very difficult to treat; CRE bloodstream infections can kill 1 in 2 patients.
The Centers for Disease Control and Prevention (CDC) tracks infections caused by bacteria producing specific enzymes including NDM-1, OXA-48 and KPC as well as VIM (Verona Integron-Mediated Metallo-β-lactamase) and IMP (Imipenemase Metallo-beta-lactamase). As of December 2017, KPC CRE infections have been reported in 50 states, and NDM-1 and OXA-48 CRE infections in over 25 states. Around a dozen states have reported VIM and IMP infections.1