Carbapenem-resistant Enterobacteriaceae, or CRE, are bacteria that can cause serious infections. These bacteria are resistant to carbapenems, which are powerful antibiotics. When these bacteria live on a person without causing illness, it is called colonization. This can be a risk for future infections. Understanding where these bacteria are most common helps health officials plan better strategies to stop their spread. This research matters to patients, families, and healthcare workers who want to know how to stay safe from drug-resistant germs. It also helps hospitals and clinics decide how to screen for these bacteria effectively.
Researchers combined data from 89 different studies to get a clear picture. These studies included a total of 116,743 participants. The participants were found in both health care settings, like hospitals, and community settings, like homes or outpatient clinics. The researchers looked at how often CRE colonization happened in these different places. They also checked if the rate changed over time or varied by country. They wanted to see if the way people were tested affected the results.
The main finding was that the overall rate of CRE colonization was 14%. This number varies widely depending on the location. In hospital settings, the rate was 18%. When hospitals used universal screening, the rate was 20%. In community settings, the rate was much lower at 3%. The study found that the hospital setting was the only factor that significantly predicted higher rates. The rate peaked at 33% in 2017 but declined to 8% in 2023. This drop suggests that efforts to control these bacteria are working in some places.
The study also looked at which bacteria were most common. Klebsiella pneumoniae made up 52.8% of the cases, while Escherichia coli made up 44.9%. The researchers also checked for specific genes that make bacteria resistant to drugs. The NDM gene was found in 45.6% of cases, and OXA-type genes were found in 36.3%. Rates varied greatly by country, with Vietnam having the highest rate at 43% and the US having the lowest at 5%. The study noted that the way studies were done also varied, which made comparing results difficult.
Because this was a meta-analysis, it combines many smaller studies. This gives a broad view but can hide details about specific patients. The study did not report safety concerns because it looked at colonization, not treatment. Colonization means the bacteria are present, but it does not mean the person is sick. However, people with colonization are at higher risk of getting an infection if they need medical care. The study authors warn that the high variability in results means one number does not fit all places.
For patients, this means that being in a hospital carries a higher risk of encountering these bacteria than being in a community setting. It does not mean a person will get infected, but it is important for hospitals to monitor these bacteria closely. The study suggests that standardized surveillance is needed. Health officials should use targeted control strategies to manage these risks. Molecular surveillance is essential to track how resistance genes change over time. Patients should talk to their doctors about infection prevention if they are in a hospital. This research highlights the need for better data collection to guide public health decisions.
