'CRE, CRO, CPE and CPO':terminology past its 'sell-by-date' in an era of new antibiotics and regional carbapenemase epidemiology

Livermore, David M, Nicolau, David P, Hopkins, Katie L and Meunier, Danièle (2020) 'CRE, CRO, CPE and CPO':terminology past its 'sell-by-date' in an era of new antibiotics and regional carbapenemase epidemiology. Clinical Infectious Diseases. ISSN 1058-4838

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Carbapenem resistance in Gram-negative bacteria is a public health concern. Numerous government and agency reports consequently discuss 'CRE' and 'CROs', meaning 'Carbapenem-Resistant Enterobacterales' or 'Carbapenem-resistant organisms'. Unfortunately these terms are fuzzy. Do they include (i) Proteeae with inherent imipenem resistance, (ii) porin-deficient Enterobacterales resistant to ertapenem but not other carbapenems, (iii) Enterobacterales with OXA-48-like enzymes that remain 'carbapenem susceptible' at breakpoint, and (iv) Pseudomonas aeruginosa that merely lack OprD? Counting carbapenemase-producing Enterobacterales/organisms ('CPE' or 'CPOs') is better but still insufficient, because different carbapenemases have differing treatment implications, particularly for new β-lactam/β-lactamase inhibitor combinations. At the least it is essential for authors, journals, and regulatory agencies to specify the carbapenemases meant. The future may demand even greater precision, for mutations can alter activity, and the ability to confer resistance, within carbapenemase families.

Item Type: Article
Additional Information: © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 25 Feb 2020 08:29
Last Modified: 23 Sep 2020 23:58
URI: https://ueaeprints.uea.ac.uk/id/eprint/74303
DOI: 10.1093/cid/ciaa122

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