Carbapenem-resistant Enterobacteriaceae in the livestock, humans and environmental samples around the globe: a systematic review and meta-analysis

This systematic review and meta-analysis examined the prevalence and factors of Carbapenem-resistant Enterobacteriaceae (CRE) infections in clinical, livestock, and environmental settings globally. The pooled prevalence of CRE was 43.06%, with Klebsiella pneumoniae, Escherichia coli, and Enterobacter cloacae being predominant. Klebsiella pneumoniae had the highest resistance with the blaKPC-2 gene, which was associated with environmental and South American studies. The study highlights the high rates of CRE infections, particularly within blaKPC production, and calls for strengthening monitoring and surveillance programs, research, and infection control measures. Further studies are needed to explore the mechanisms driving the predominance of specific bacterial species and the distribution of resistance genes within this bacterial family.