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Life sciences · Journal article
Antibiotics · August 15, 2026
A consensus or society position rather than new primary data.
This narrative review consolidates evidence on carbapenem-resistant Enterobacterales (CRE) epidemiology and European surveillance infrastructure, identifying critical gaps in harmonization, genomic capacity, and cross-border coordination. The authors recommend integrated, One Health–aligned surveillance combining microbiological, genomic, epidemiological, and antimicrobial consumption data as a priority for improved CRE prevention and control across Europe.
Narrative review. European healthcare systems and surveillance networks monitoring carbapenem-resistant Enterobacterales.. Europe.
CRE, particularly carbapenem-resistant Klebsiella pneumoniae, represent one of the most important antimicrobial resistance threats in Europe, driven by dissemination of high-risk clones and horizontal transfer of mobile genetic elements. Substantial heterogeneity persists among European countries in microbiological and genomic diagnostic capacity, reporting practices, infection prevention and control, antimicrobial stewardship, healthcare infrastructure, and national policy implementation. Existing European surveillance infrastructures (EARS-Net, EURGen-Net, HAI-Net, ESAC-Net, PPS, EpiPulse/TESSy, CAESAR, WHO GLASS) are well-established but lack harmonization, limiting data comparability and delaying detection of colonization, outbreaks, and cross-border transmission.
Existing European surveillance infrastructures (EARS-Net, EURGen-Net, HAI-Net, ESAC-Net, PPS, EpiPulse/TESSy, CAESAR, WHO GLASS) are well-established but lack harmonization, limiting data comparability and delaying detection of colonization, outbreaks, and cross-border transmission.
Clinicians and public health officials should recognize that CRE surveillance and preparedness remain fragmented across Europe; coordinated implementation of genomic surveillance, harmonized indicators, and antimicrobial stewardship is essential to close gaps in outbreak detection and cross-border infection prevention.
A narrative review synthesizing surveillance infrastructure, epidemiological evidence, and expert recommendations for CRE control across Europe, without presenting new primary data or clinical trial results.
As stated by the source record.
Clinicians and public health officials should recognize that CRE surveillance and preparedness remain fragmented across Europe; coordinated implementation of genomic surveillance, harmonized indicators, and antimicrobial stewardship is essential to close gaps in outbreak detection and cross-border infection prevention.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Carbapenem-resistant Enterobacterales (CRE) represent one of the most important antimicrobial resistance threats in Europe, particularly in healthcare settings. Their increasing epidemiological significance is driven by the dissemination of carbapenem-resistant Klebsiella pneumoniae, the emergence of high-risk clones, horizontal transfer of mobile genetic elements, and the convergence of antimicrobial resistance and hypervirulence. Despite the growing epidemiological importance of CRE, surveillance and preparedness remain heterogeneous across European countries, creating a need for a continent-wide assessment of existing surveillance systems, implementation gaps, and emerging challenges. This narrative review summarizes the current epidemiology of CRE in Europe and critically discusses the role of European and global surveillance systems in monitoring their spread. Particular attention is given to the European Antimicrobial Resistance Surveillance Network (EARS-Net), European Antimicrobial Resistance Genes Surveillance Network (EURGen-Net), Healthcare-Associated Infections Surveillance Network (HAI-Net), European Surveillance of Antimicrobial Consumption Network (ESAC-Net), Point Prevalence Survey (PPS), EpiPulse/TESSy, the Central Asian and European Surveillance of Antimicrobial Resistance (CAESAR) programme, and the World Health Organization Global Antimicrobial Resistance and Use Surveillance System (WHO GLASS). Although Europe has well-established surveillance infrastructures, substantial heterogeneity persists among countries with respect to microbiological and genomic diagnostic capacity, reporting practices, infection prevention and control (IPC), antimicrobial stewardship, healthcare infrastructure, and implementation of national policies. These differences limit data comparability and may delay the detection of colonization, outbreaks, and cross-border transmission. The available evidence indicates that effective CRE control requires integrated surveillance combining microbiological, genomic, epidemiological, and antimicrobial consumption data within a coordinated One Health framework. Further expansion of genomic surveillance, harmonization of surveillance indicators, strengthening of healthcare system preparedness, and wider implementation of antimicrobial stewardship programmes are identified as priority areas for improve CRE prevention and control across Europe. By integrating evidence across surveillance, diagnostics, infection prevention and control, and antimicrobial stewardship, this review highlights key gaps in current European approaches and provides a framework for prioritizing future surveillance and preparedness efforts.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.