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CRE Resistance Mechanisms

Several mechanisms are responsible for carbapenem resistance among Enterobacteriaceae. One important mechanism is the production of a carbapenemase, an enzyme that efficiently breaks down carbapenem antibiotics. 

Carbapenemases reported in the United States include:

Klebsiella pneumoniae carbapenemase (KPC)

Metallo-β-lactamases (MBLs)

New Delhi metallo-β-lactamase (NDM-1)

  • Clinicians should call MDH Acute Disease Investigation & Control at 651-201-5414 or toll free 1-877-676-5414 if treating a patient in which a CRE is detected and who has received medical care in India or Pakistan within the past 6 months.

Verona integron-encoded metallo-β-lactamase (VIM)

Imipenemase metallo-β-lactamase (IMP)

  • CDC has also identified a CRE isolate caused by the IMP enzyme.

Updated Friday, May 31, 2013 at 09:07AM