Carbapenem-resistant Enterobacterales (CRE) are a growing threat to human health worldwide. CRE often carry multiple resistance genes that limit treatment options and require longer durations of therapy, are more costly to treat, and necessitate therapies with increased toxicities when compared with carbapenem-susceptible strains. Here, we provide an overview of the mechanisms of resistance in CRE, the epidemiology of CRE infections worldwide, and available treatment options for CRE. We review recentlyapproved agents for the treatment of CRE, including ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, cefiderocol, and novel aminoglycosides and tetracyclines. We also discuss recent advances in phage therapy and antibiotics that are currently in development targeted to CRE. The potential for the development of resistance to these therapies remains high, and enhanced antimicrobial stewardship is imperative both to reduce the spread of CRE worldwide and to ensure continued access to efficacious treatment options.

耐碳青霉烯肠杆菌 (CRE) 对全世界人类健康构成日益严重的威胁。与碳青霉烯类敏感菌株相比，CRE 通常携带多种耐药基因，这些基因限制了治疗选择，需要更长的治疗时间，治疗成本更高，并且需要毒性增加的治疗。在这里，我们概述了 CRE 的耐药机制、全球 CRE 感染的流行病学以及 CRE 的可用治疗方案。我们回顾了最近批准的用于治疗 CRE 的药物，包括头孢他啶-阿维巴坦、美罗培南-瓦波巴坦、亚胺培南-瑞巴坦、头孢地考以及新型氨基糖苷类和四环素。我们还讨论了目前正在开发的针对 CRE 的噬菌体治疗和抗生素的最新进展。