• Ali A Rabaan, Khalid Eljaaly, Saad Alhumaid, Hawra Albayat, Wasl Al-Adsani, Amal A Sabour, Maha A Alshiekheid, Jumana M Al-Jishi, Faryal Khamis, Sara Alwarthan, Mashael Alhajri, Amal H Alfaraj, Huseyin Tombuloglu, Mohammed Garout, Duaa M Alabdullah, Elmoeiz Ali Elnagi Mohammed, Fatimah S Al Yami, Haifa A Almuhtaresh, Kovy Arteaga Livias, MutairAbbas AlAAResearch Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia.College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia.School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia., Shawqi A Almushrif, Mai Abdel Haleem A Abusalah, and Naveed Ahmed.
• Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia.
• Medicina (Kaunas). 2022 Nov 19; 58 (11).

AbstractImproper use of antimicrobials has resulted in the emergence of antimicrobial resistance (AMR), including multi-drug resistance (MDR) among bacteria. Recently, a sudden increase in Carbapenem-resistant Enterobacterales (CRE) has been observed. This presents a substantial challenge in the treatment of CRE-infected individuals. Bacterial plasmids include the genes for carbapenem resistance, which can also spread to other bacteria to make them resistant. The incidence of CRE is rising significantly despite the efforts of health authorities, clinicians, and scientists. Many genotypic and phenotypic techniques are available to identify CRE. However, effective identification requires the integration of two or more methods. Whole genome sequencing (WGS), an advanced molecular approach, helps identify new strains of CRE and screening of the patient population; however, WGS is challenging to apply in clinical settings due to the complexity and high expense involved with this technique. The current review highlights the molecular mechanism of development of Carbapenem resistance, the epidemiology of CRE infections, spread of CRE, treatment options, and the phenotypic/genotypic characterisation of CRE. The potential of microorganisms to acquire resistance against Carbapenems remains high, which can lead to even more susceptible drugs such as colistin and polymyxins. Hence, the current study recommends running the antibiotic stewardship programs at an institutional level to control the use of antibiotics and to reduce the spread of CRE worldwide.

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