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Narrative review examines carbapenem-resistant E. coli and One Health approach in AMR governanceReview offers theoretical support for managing carbapenem-resistant E. coli in public health

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Consider theoretical insights on CREC and One Health in AMR policy.

This publication is a narrative review focusing on carbapenem-resistant Escherichia coli (CREC) and its role in antimicrobial resistance (AMR) governance. The review synthesizes existing literature to discuss the challenges posed by CREC, without reporting specific study populations, interventions, comparators, or outcomes from primary trials. Its scope includes theoretical and policy-oriented aspects of managing this resistant pathogen.

The key arguments synthesized by the authors center on the integration of a One Health approach in AMR governance. They highlight how understanding CREC can inform evidence-based public health policy and support anti-infective clinical practice theoretically. The review does not provide pooled effect sizes, p-values, or confidence intervals, as it is not a meta-analysis or primary study, but rather a qualitative discussion of existing knowledge.

Limitations are not explicitly detailed in the source, but as a narrative review, it may lack systematic methods for literature selection and synthesis, potentially introducing bias. The authors do not report funding or conflicts of interest. In terms of practice relevance, the review offers theoretical support for clinical practice and public health policy, facilitating the implementation of the One Health approach in AMR governance, but clinicians should rely on direct evidence from trials for specific interventions.

This study is a narrative review, meaning it summarizes existing information rather than testing a new idea on people or animals. It focuses on carbapenem-resistant Escherichia coli, a specific bacteria that has become difficult to treat with certain powerful antibiotics. The authors gathered current knowledge to help guide how doctors and health officials handle these infections.

The review suggests that understanding these resistant bacteria helps improve clinical care and public health strategies. It aims to inform policies on antimicrobial resistance and supports the One Health approach, which connects human, animal, and environmental health. This broad perspective is important for stopping the spread of resistant germs across different settings.

Readers should understand that this work provides a foundation for decision-making but does not report new patient data or specific drug trials. There were no safety concerns reported because the study did not test a new medication. While the information is useful for planning, it does not replace direct medical advice or immediate changes to individual treatment plans.

What this means for you:
This review supports current strategies for managing carbapenem-resistant E. coli in public health.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
Carbapenem-resistant Escherichia coli (CREC) has emerged as a critical global health concern, particularly strains carrying the blaNDM-5-IncX3 plasmid. In this review, we synthesize recent advances in the molecular epidemiology, resistance mechanisms especially the transmission dynamics of the blaNDM-5-IncX3 plasmid, virulence factors, research methodologies, and current strategies for the prevention and control of CREC. We further explore the cross-species dissemination and adaptive evolution of blaNDM-5-IncX3 plasmids within the interconnected human-animal-environment interface. Based on these insights, we propose a novel triadic transmission model—”structural adaptation, host reciprocity, and environmental driving”, alongside a One Health-based, multidimensional intervention framework spanning clinical, agricultural, and environmental domains. This review provides critical perspectives for the containment of carbapenem-resistant Enterobacteriaceae, offers theoretical support for anti-infective clinical practice, informs evidence-based public health policy, and facilitates the implementation of the One Health approach in antimicrobial resistance (AMR) governance.
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