Carbapenem-Resistant Enterobacterales (CRE) Surveillance, Infection and Epidemiology

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 164

Special Issue Editor


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Guest Editor
Azienza Ospedaliero Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy
Interests: health surveillance and promotion; molecular epidemiology; carbapenem-resistant enterobacterales infection; viral hepatitis infection; antibiotic resistance

Special Issue Information

Dear Colleagues,

Carbapenem-resistant Enterobacterales (CRE) are among the most urgent threats to healthcare systems worldwide because of their rapid spread, limited treatment options, and major impact on patient safety, clinical outcomes, and hospital organization. In endemic settings, the early identification of colonized patients is essential to support timely isolation, optimize patient placement, and reduce the risk of healthcare-associated transmission.

Risk-based screening has emerged as a pragmatic alternative to universal screening, particularly in hospitals with a high CRE burden and limited operational resources. However, important questions remain regarding the real-world yield of these strategies, the most relevant screening criteria, their epidemiological value, and their integration into broader infection prevention and control pathways.

This Special Issue aims to collect high-quality contributions addressing screening, surveillance, and infection prevention strategies for CRE and carbapenemase-producing Enterobacterales (CPE) across healthcare settings. Particular interest will be given to studies on pre-admission screening, admission risk assessment, active surveillance cultures, molecular characterization of resistance mechanisms, colonization burden, and interventions designed to reduce transmission. Contributions exploring the intersection between microbiology, hospital epidemiology, infection prevention, antimicrobial stewardship, and healthcare organization are especially welcome.

In this Special Issue, original research articles and reviews are welcome. Research areas may include, but are not limited to, the following: risk-based screening models; pre-admission and admission screening; colonization surveillance; carbapenemase genes and molecular epidemiology; infection prevention and control; hospital transmission; antimicrobial stewardship; and organizational strategies for endemic multidrug-resistant pathogens.

We look forward to receiving your contributions.

Dr. Daniela Loconsole
Guest Editor

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Keywords

  • carbapenem-resistant Enterobacterales
  • CRE
  • carbapenemase-producing Enterobacterales
  • CPE
  • pre-admission screening
  • risk-based screening
  • infection prevention and control
  • antimicrobial resistance
  • hospital epidemiology
  • colonization surveillance
  • carbapenemase genes

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Published Papers (1 paper)

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Research

13 pages, 508 KB  
Article
Risk-Based Pre-Admission Screening for Carbapenem-Resistant Enterobacterales (CRE): A Patient-Level Observational Study in a High-Endemic European Setting
by Salvatore Altavilla, Daniela Loconsole, Nicoletta Di Pietro, Rossella Memmola, Donato Sivo and Francesco Di Gennaro
Microorganisms 2026, 14(6), 1262; https://doi.org/10.3390/microorganisms14061262 (registering DOI) - 3 Jun 2026
Abstract
Multidrug-resistant organisms, particularly carbapenem-resistant Enterobacterales (CRE), represent a major global health threat. In settings with endemic circulation of carbapenem-resistant organisms, early identification of colonised patients before hospital admission may play a critical role in limiting in-hospital spread and guiding infection prevention strategies. We [...] Read more.
Multidrug-resistant organisms, particularly carbapenem-resistant Enterobacterales (CRE), represent a major global health threat. In settings with endemic circulation of carbapenem-resistant organisms, early identification of colonised patients before hospital admission may play a critical role in limiting in-hospital spread and guiding infection prevention strategies. We conducted a retrospective monocentric observational study including all patients evaluated for hospital admission in 2025. Patients presenting predefined epidemiological or clinical risk factors underwent risk-based pre-admission screening for CRE. Patient-level deduplication was applied to microbiologically positive records. Among 2694 patients evaluated for hospital admission, 1084 met predefined screening criteria and underwent rectal swab testing. Overall, 191 unique patients were confirmed as carriers of carbapenemase-producing Enterobacterales, corresponding to 17.6% of screened patients and 7.1% of the overall cohort evaluated for admission. KPC was the most prevalent carbapenemase gene (102/191, 53.4%), followed by NDM (57/191, 29.8%) and KPC/NDM co-production (14/191, 7.3%). Less frequent gene profiles included VIM, OXA-48, and combined carbapenemase patterns. In high-endemic healthcare settings, risk-based pre-admission screening may represent a pragmatic component of infection prevention pathways by supporting early identification of patients with probable CRE/CPE carriage. When analysed at the patient level, such programmes can provide useful operational and epidemiological information for admission management and infection control planning. Full article
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