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Report Overview
Carbapenem-resistant Enterobacterales (CRE) are Enterobacterales that are resistant to at least one carbapenem antimicrobial, creating infections for which treatment options can be substantially restricted. WHO's 2024 Bacterial Priority Pathogens List places carbapenem-resistant Enterobacterales in the critical-priority category, reflecting their burden, transmissibility and limited treatment options. According to Carbapenem-resistant Enterobacterales (CRE) Epidemiology Forecast by Expert Market Research, CRE contributes to the broader antimicrobial-resistance and infectious-disease therapeutic landscape, particularly through hospital infections requiring advanced antibacterial treatment and susceptibility-guided management.
2025
Base Year
2019-2025
Historical Period
2026-2035
Forecast Period
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Carbapenem-Resistant Enterobacteriaceae (CRE) Epidemiology Forecast Report Coverage
Expert Market Research's “Carbapenem-Resistant Enterobacteriaceae (CRE) Epidemiology Forecast Report 2026-2035” offers comprehensive information on the prevalence and demographics of Carbapenem-Resistant Enterobacteriaceae (CRE). It projects the future incidence and prevalence rates of Carbapenem-Resistant Enterobacteriaceae (CRE) cases across various populations. The study covers age, gender, and type as major determinants of the Carbapenem-Resistant Enterobacteriaceae (CRE) population. The report highlights patterns in the prevalence of Carbapenem-Resistant Enterobacteriaceae (CRE) overtime and projects future trends based on multiple variables.
The report provides a comprehensive overview of the disease, as well as historical and projected data on the epidemiology of Carbapenem-Resistant Enterobacteriaceae (CRE) in the 8 major markets.
Regions Covered
- United States
- Germany
- France
- Italy
- Spain
- United Kingdom
- Japan
- India
Carbapenem-Resistant Enterobacteriaceae (CRE) Understanding: Disease Overview
Carbapenem-resistant Enterobacterales (CRE) are Enterobacterales that are resistant to at least one carbapenem antimicrobial, creating infections for which treatment options can be substantially restricted. The group includes clinically important organisms such as Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, Klebsiella oxytoca and Klebsiella aerogenes. Resistance may arise through carbapenemase production, permeability changes, efflux mechanisms or combinations of β-lactamase production and porin alteration. Carbapenemase-producing CRE are of particular epidemiological concern because enzymes such as KPC, NDM, OXA-48-like, VIM and IMP can mediate resistance to multiple β-lactam agents and facilitate transmission of resistance determinants between bacterial populations. WHO's 2024 Bacterial Priority Pathogens List places carbapenem-resistant Enterobacterales in the critical-priority category, reflecting their burden, transmissibility and limited treatment options.
Key Report Insights
|
Parameter |
Insight |
|
Largest Patient Pool |
United States |
|
Fastest Growing Country |
United States |
|
High-Risk Population |
Older adults, ICU patients, patients with prolonged healthcare exposure, long-term-care residents, individuals with invasive urinary or central venous devices, dialysis patients, transplant recipients and people with substantial comorbidity. |
|
Key Diagnostic Method |
Phenotypic antimicrobial susceptibility testing followed by carbapenemase detection and molecular characterization when appropriate; major mechanisms include KPC, NDM, OXA-48-like, VIM and IMP. |
|
Major Risk Factor |
Previous healthcare exposure, invasive devices and antimicrobial exposure. In U.S. 2023 surveillance, 64.7% had a healthcare-facility stay during the preceding year and 34.8% had a urinary catheter shortly before specimen collection. |
|
Major gap in the market |
Heterogeneous definitions, incomplete screening of asymptomatic carriers, substantial healthcare-to-healthcare transmission, variable carbapenemase testing and limited population-based surveillance in many countries complicate estimation of true CRE burden. |
Carbapenem-Resistant Enterobacteriaceae (CRE) Epidemiology Perspective
The Carbapenem-Resistant Enterobacteriaceae (CRE) epidemiology division offers information on the patient pool from history to the present as well as the projected trend for each of the 8 major markets. Expert Market Research provides both current and predicted trends for the Carbapenem-Resistant Enterobacteriaceae (CRE) epidemiology scenario by examining a wide range of studies. Additionally, the report covers the diagnosed patient pool for Carbapenem-Resistant Enterobacteriaceae (CRE) and their trends. The data is broken down into specific categories, such as total prevalent cases in males and females, and total diagnosed cases across different age groups and patient pools.
|
Epidemiology Segment |
Key Insights |
|
Diagnosed Prevalent Cases of the Disease |
1,773 incident cases were identified in CDC EIP surveillance, corresponding to 7.7 cases per 100,000 population. Urinary infection accounted for 65.1% and bacteremia for 14.8%. EU-wide incidence of carbapenem-resistant K. pneumoniae bloodstream infection was estimated at 3.97 per 100,000 population, with substantial country-level heterogeneity |
|
Gender-Specific Cases of the Disease |
U.S. 2023 incidence was 8.7 per 100,000 in females versus 6.5 in males; females represented 58.0% of reported cases. |
|
Age-Specific Cases of the Disease |
U.S. incidence increased from 0.7 per 100,000 among 0-18-year-olds to 57.5 per 100,000 among people aged ≥80 years in 2023. |
|
Ethnicity-Wise Cases of the Disease |
U.S. 2023 incidence was highest among non-Hispanic American Indian/Alaska Native (14.8 per 100,000) and non-Hispanic Black/African American (10.3 per 100,000) populations. These are population disparities rather than evidence of inherent biological susceptibility. |
|
Mortality and Survival Analysis of the Disease |
CDC recorded 86 deaths within 30 days in 2023, corresponding to 4.9% of all incident cases; mortality reached 17.4% among cases with an incident sterile-site specimen. England reported 24.1% 30-day all-cause mortality among patients with CPOs isolated from sterile sites in 2024. |
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Country-wise Carbapenem-Resistant Enterobacteriaceae (CRE) Epidemiology
The Carbapenem-Resistant Enterobacteriaceae (CRE) epidemiology data and findings for the United States, Germany, Spain, Italy, France, the United Kingdom, Japan, and India are also provided in the epidemiology section.
|
Country |
Key Insights |
|
United States |
CDC EIP identified 1,773 incident CRE cases in 2023, corresponding to 7.7 cases per 100,000 population. Females had higher incidence than males, and incidence increased substantially with age. Of 666 isolates undergoing molecular characterization, 38.3% were carbapenemase-producing. |
|
Germany |
Germany remains within the European surveillance framework for carbapenem-resistant Enterobacterales. Contemporary ECDC data demonstrate that carbapenem-resistant K. pneumoniae bloodstream infections remain present, although a single nationally comparable all-CRE case count for 2023–2026 was not identified in the reviewed sources. |
|
France |
France is a contemporary European CRE setting with carbapenem-resistant K. pneumoniae bloodstream infections captured through EARS-Net. However, a directly comparable national all-CRE 2023–2026 incidence series was not identified in the reviewed evidence, so no unsupported national CRE total is inserted. |
|
Italy |
Italy represents an important European setting for carbapenem-resistant Enterobacterales, particularly carbapenem-resistant K. pneumoniae. Current EARS-Net surveillance shows substantial carbapenem-resistant bloodstream infection burden, although national CRE totals should not be inferred from the K. pneumoniae bloodstream denominator. |
|
Spain |
Spain participates in EARS-Net surveillance and reports carbapenem-resistant Enterobacterales, including carbapenem-resistant K. pneumoniae bloodstream infection. A directly comparable all-CRE national patient count for 2023–2026 was not identified in the reviewed evidence. |
|
United Kingdom |
England identified 212 first C. auris detections in 2024. Between January 2023 and September 2025, 496 patients were reported, 84% colonized and 14% invasive. London and South East England accounted for approximately 92% of reported cases. |
|
Japan |
Japan's contemporary national response recognizes C. auris as an emerging infection-control concern. The country had identified its first invasive bloodstream infection before the 2023–2026 period, but a nationally comparable 2023–2026 case series sufficient for direct ranking was not identified in the current evidence review. |
|
India |
No nationally representative 2023–2026 C. auris incidence estimate was identified. Contemporary tertiary-care evidence demonstrates a substantial clinical burden in selected hospitals; one South Indian study found 85 of 372 candidemia episodes (22.8%) were caused by C. auris. |
Key Market Gaps, Untapped Opportunities, and Emerging Growth Areas in the Regional Disease Epidemiology Landscape
The primary epidemiological gap in CRE is the absence of a universally consistent definition and surveillance framework across countries. CDC's U.S. EIP system defines an incident case using resistance among specified Enterobacterales isolated from urine or normally sterile sites, whereas European surveillance frequently reports resistance within bloodstream isolates of individual species such as K. pneumoniae. England's national reference system focuses heavily on carbapenemase-producing organisms referred for specialized testing. These approaches measure related but non-identical phenomena, making global incidence comparisons intrinsically uncertain.
Carbapenem-Resistant Enterobacteriaceae (CRE): Treatment Overview
The management of Carbapenem-Resistant Enterobacterales infection primarily focuses on accurate species and resistance-mechanism identification, severity assessment, susceptibility-guided antimicrobial treatment, source control and prevention of healthcare-associated transmission. Unlike susceptible Enterobacterales infections, CRE management requires particular attention to the carbapenemase mechanism because susceptibility to one newer β-lactam/β-lactamase inhibitor does not necessarily predict activity against organisms carrying another resistance mechanism. Contemporary reviews therefore emphasize individualized treatment based on molecular or phenotypic characterization whenever feasible.
Key Questions Answered
- What is the current and projected burden of Carbapenem-Resistant Enterobacteriaceae (CRE) across the 8 major markets?
- Which countries across the 8 major markets account for the highest Carbapenem-Resistant Enterobacteriaceae (CRE) patient populations and fastest growth rates?
- What is the diagnosed versus undiagnosed patient population of Carbapenem-Resistant Enterobacteriaceae (CRE) across key countries in the 8 major markets?
- Which countries demonstrate the largest gaps in screening, early diagnosis, and disease awareness of Carbapenem-Resistant Enterobacteriaceae (CRE) across the 8 major markets?
- What are the major drivers contributing to the increasing burden of Carbapenem-Resistant Enterobacteriaceae (CRE) across the 8 major markets?
- How do major comorbidities and risk factors influence Carbapenem-Resistant Enterobacteriaceae (CRE) epidemiology trends across the 8 major markets?
- What are the regional trends in advanced disease progression, treatment uptake, and patient management of Carbapenem-Resistant Enterobacteriaceae (CRE) across the 8 major markets?
- Which patient segments represent the highest unmet clinical need in the Carbapenem-Resistant Enterobacteriaceae (CRE) landscape across the 8 major markets?
- Which therapeutic areas linked to Carbapenem-Resistant Enterobacteriaceae (CRE) are expected to witness the strongest growth opportunities across the 8 major markets?
- How is the Carbapenem-Resistant Enterobacteriaceae (CRE) epidemiology landscape expected to evolve over the next 5 to 10 years across the 8 major markets?
- Which countries across the 8 major markets offer the most attractive market opportunities based on Carbapenem-Resistant Enterobacteriaceae (CRE) epidemiology and healthcare infrastructure?
- Which epidemiological trends are expected to influence future drug development and market access strategies for Carbapenem-Resistant Enterobacteriaceae (CRE) across the 8 major markets?
Scope of the Carbapenem-Resistant Enterobacteriaceae (CRE) Epidemiology Report
- The report covers a detailed analysis of signs and symptoms, causes, risk factors, pathophysiology, diagnosis, treatment options, and classification/types of Carbapenem-Resistant Enterobacteriaceae (CRE) based on several factors.
- Carbapenem-Resistant Enterobacteriaceae (CRE) Epidemiology Forecast Report covers data for the eight major markets (the US, France, Germany, Italy, Spain, the UK, Japan, and India).
- The Carbapenem-Resistant Enterobacteriaceae (CRE) report helps to identify the patient population, and the unmet needs are highlighted along with an assessment of the disease's risk and burden.
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Report Summary
Explore our key highlights of the report and gain a concise overview of key findings, trends, and actionable insights that will empower your strategic decisions.
|
Report Features |
Details |
|
Base Year |
2025 |
|
Historical Period |
2019-2025 |
|
Forecast Period |
2026-2035 |
|
Epidemiology Statistics Provided |
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|
Segmentation Provided |
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Geographies Covered |
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