Carbapenem-Resistant Enterobacterales
Hospitalized Infections
55.3% of cases were hospitalized
30-day Crude Mortality
- Overall cases:
- 5.6%
- Cases with a sterile site specimen:
- 18.4%
- Cases with a urine specimen:
- 3.5%
Infections by Race
- White:
- 60.4%
- Black or African American:
- 23.7%
- Asian:
- 4.8%
- American Indian, Alaska Native:
- 0.7%
- Other or unknown race:
- 10.4%
MuGSI Data Profile
Carbapenem-Resistant Enterobacterales
Enterobacterales are a group of bacteria that are normally part of the human and animal gastrointestinal tract but can also cause infections. Carbapenem-resistant Enterobacterales (CRE) are resistant to one or several carbapenems, which are one of the last-line antibiotics used to treat serious multidrug-resistant infections. A subset of CRE can produce carbapenemases, which are enzymes that inactivate carbapenems and other β-lactam antibiotics. Carbapenemase-producing CRE can share the genetic code for carbapenemases with other bacteria, rapidly spreading resistance.
CRE causes urinary tract infections and invasive infections, including bloodstream infections and pneumonia, that can be associated with high mortality rates.
CRE spreads through direct or indirect contact with patients infected or colonized with CRE or contaminated environmental surfaces and equipment. Patients in healthcare settings who receive complex medical care, including having invasive devices and long courses of antibiotics, or who need help with activities like toileting, bathing, and dressing, are at most risk for CRE.
CDC provides guidelines and tools to the healthcare community to help prevent CRE as well as provides resources to help the public safeguard their own health.
- Data Source
- Emerging Infections Program (EIP)
- Years Included
- 2012 - 2022
- Resources
- Multi-site Gram-negative Surveillance Initiative (MuGSI)
- Carbapenem-resistant Enterobacterales (CRE) Infection Control
- About Carbapenem-resistant Enterobacterales
- Antimicrobial Resistance Lab Network
- Antimicrobial Resistance Threats in the United States, 2021-2022
- 2019 Antibiotic Resistance Threats Report
CRE Infections in EIP Sites
CRE Infections in EIP Sites
Rates of CRE in EIP surveillance area
Note: CRE surveillance includes urine and normally sterile site specimens. From 2012–2015, the phenotypic surveillance definition for Carbapenem-resistant Enterobacterales (CRE) was: an intermediate or resistant antimicrobial susceptibility test result for ≥1 carbapenem (doripenem, imipenem, or meropenem) and a resistant antimicrobial susceptibility test result for all third generation cephalosporins (ceftazidime, ceftriaxone, and cefotaxime) tested. Since 2016, the phenotypic surveillance definition is: a resistant antimicrobial susceptibility test result for ≥1 carbapenem (doripenem, ertapenem, imipenem, or meropenem). The minimum inhibitory concentrations or zone diameters reported by the local clinical laboratories were used to classify isolates.
Footnotes
- Surveillance areas have changed over time. The number of EIP sites participating in surveillance is as follows: 2012 – 3 sites; 2013 – 7 sites; 2014-2016 – 8 sites; 2017 – 9 sites; 2018 to present – 10 sites.