IN A SINGLE YEAR, CRE CAUSED3†
~13,100 infections among hospitalized patients
1100 deaths nationwide
†Based on the CDC’s 2017 estimate.
Changing dynamics of resistance
Antimicrobial resistance
The changing dynamics of resistance among CRE in the United States
Metallo-β-lactamases (MBLs) are becoming more common1,2
- At the same time, the frequency of Klebsiella pneumoniae carbapenemase (KPC)–producing pathogens has been steadily decreasing since 2019
Data are based on 391 carbapenem-resistant Enterobacterales (CRE) isolates, taken from a larger pool of Enterobacterales isolates collected from 74 US medical centers between 2019 and 2023 through the International Network for Optimal Resistance Monitoring (INFORM) Antimicrobial Surveillance Program.2
Frequencies of select carbapenemase subtypes from CRE isolates1,2
% CREs
YEARS
- OXA-48—like
- MBL*
- KPC
Pinch to zoom in on chart
Frequency of non-carbapenemase-producing CRE was generally stable across all 5 years, ranging from 14.1% to 23.9%.1,2
*Includes New Delhi metallo-β-lactamase type (90.1%), imipenemase type (8.5%), and Verona integron-encoded metallo-β-lactamase type (1.4%).1,2
CRE—an urgent threat, a growing burden
A threat to public health
In the United States, CRE is considered an urgent public health threat by the Centers for Disease Control and Prevention.3
A top infectious disease priority worldwide
In discussing the need for new anti-infective agents, the World Health Organization has listed CRE as a critical priority pathogen for research and development.4,5
The burden of CRE infections
In a retrospective cohort study of 175 US hospitals from 2009 to 2013 (N=40,137), patients with CRE infections experienced a:
readmission rate at 30 days6
For carbapenem-susceptible Enterobacterales, the readmission rate at 30 days was 21.5%.
In a prospective, observational study of hospitalized patients in the United States infected with carbapenem-resistant K pneumoniae (N=287) from 2011 to 2013:
were readmitted within 90 days with the same index pathogen7
higher risk of mortality
for patients infected with CRE vs those with carbapenem-susceptible Enterobacterales8
MBL-producing Enterobacterales are particularly challenging to treat
In an analysis of 63,194 isolates collected from 208 medical centers in 40 countries from 2012 to 2015:
>80%
OF MBL-PRODUCING ISOLATES ALSO
PRODUCED 1 OR MORE SERINE
β-LACTAMASES9
Stenotrophomonas maltophilia can also coproduce serine β-lactamases and MBLs10
- S maltophilia is resistant to most classes of β-lactams, including carbapenems, due to intrinsic production of both MBL and serine β-lactamases10
- Additional mechanisms of resistance may impact other classes of antibiotics, such as aminoglycosides, tetracyclines, and sulfonamides11
- The efficacy of EMBLAVEO in treating clinical infections caused by S maltophilia has not been established in adequate and well-controlled clinical trials
References: 1. Sader HS, Mendes RE, Carvalhaes CG, Kimbrough JH, Castanheira M. Open Forum Infect Dis. 2023;10(2):ofad046. doi:10.1093/ofid/ofad046 2. Data on file. AbbVie, Inc. 3. Duffy N, Li R, Czaja CA, et al. Open Forum Infect Dis. 2023;10(12):ofad609. doi:10.1093/ofid/ofad609 4. Piérard D, Hermsen ED, Kantecki M, Arhin FF. Antibiotics (Basel). 2023;12(11):1591. doi:10.3390/antibiotics12111591 5. Tacconelli E, Carrara E, Savoldi A, et al. Lancet Infect Dis. 2018;18(3):318-327. doi:10.1016/S1473-3099(17)30753-3 6. Zilberberg MD, Nathanson BH, Sulham K, Fan W, Shorr AF. Antimicrob Resist Infect Control. 2017;6:124. doi:10.1186/s13756-017-0286-9 7. Messina JA, Cober E, Richter SS, et al. Infect Control Hosp Epidemiol. 2016;37(3):281-288. doi:10.1017/ice.2015.298 8. Martin A, Fahrbach K, Zhao Q, Lodise T. Open Forum Infect Dis. 2018;5(7):ofy150. doi:10.1093/ofid/ofy150 9. Karlowsky JA, Kazmierczak KM, de Jonge BLM, Hackel MA, Sahm DF, Bradford PA. Antimicrob Agents Chemother. 2017;61(9):e00472-17. doi:10.1128/AAC.00472-17 10. Banar M, Sattari-Maraji A, Bayatinejad G, et al. Front Med (Lausanne). 2023;10:1163439. doi:10.3389/fmed.2023.1163439 11. Mojica MF, Humphries R, Lipuma JJ, et al. JAC Antimicrob Resist. 2022;4(3):dlac040. doi:10.1093/jacamr/dlac040
