Carbapenem Resistant Enterobacteriaceae Infection Epidemiology Forecast

DelveInsight’s ‘Carbapenem-resistant Enterobacteriaceae Infection – Epidemiology Forecast – 2030’ report delivers an in-depth understanding of the historical and forecasted epidemiology of Carbapenem-resistant Enterobacteriaceae Infection in the United States, EU5 (Germany, Spain, Italy, France, and the United Kingdom), and Japan.

Geography Covered

  • The United States
  • EU5 (Germany, France, Italy, Spain, and the United Kingdom)
  • Japan

Study Period: 2018–2030

Carbapenem-resistant Enterobacteriaceae Infection: Disease Understanding

Carbapenem-resistant Enterobacteriaceae Infection Overview

Carbapenems, a class of ß-lactam antibiotics with a broad spectrum of activity, have been the workhorse for treating difficult Gram-negative infections, but with the increasing use of carbapenems in clinical practice, the emergence of carbapenem-resistant pathogens now poses a great threat to human health. The Centers for Disease Control and Prevention (CDC) defines Carbapenem-resistant Enterobacteriaceae (CRE) as enterobacteria non-susceptible to any carbapenem or documented to produce carbapenemases. These pathogens have also been described as “nightmare” bacteria by CDC. Also, in 2017, WHO categorized CRE within the critical priority group, against which there is an urgent need to develop new antibiotics.


Symptoms of a CRE infection vary. They may differ with the type of bacteria involved and the part of the body infected. Some general symptoms of a CRE infection include fever and a rapid pulse. Based on carbapenemase production, CRE is classified into carbapenemase-producing CRE and non- carbapenemase-producing CRE.


There are three major mechanisms by which Enterobacteriaceae become resistant to carbapenems: enzyme production (carbapenemases), efflux pumps, and porin mutations. Of these, enzyme production is the main resistance mechanism. CP-CRE can produce a large variety of carbapenemases, divided into three groups according to the Ambler classification: Class A, Class B, and Class D ß-lactamases. There is a fourth class, Ambler class C; however, its clinical relevance remains unknown.


Tests to detect CP-CRE include Chromogenic assays, modified Hodge test, and Metallo- β-lactamase Etest, but these tests do not identify specific carbapenemases. Various rapid diagnostic phenotypic tests (e.g., Carba NP, mCIM, eCIM, and MALDI-TOF MS) may detect carbapenemase production, whereas several rapid diagnostic genotypic tests (e.g., Biofire FilmArray, Verigene System, Xpert Carba-R, GenMark ePlex) may identify specific carbapenemases.


To date, the treatment options for CRE infections remain very limited. Polymyxins (colistin or polymyxin B) and tigecycline have been historically considered drugs of choice for infections caused by CRE. However, resistance to these antibiotics is increasing. In addition to polymyxins and tigecycline, fosfomycin and aminoglycosides are occasionally used. Carbapenems still play a role in treating CRE infections, particularly when used in the treatment of CRE with lower MICs, either in higher doses, in combination with other active anti-CRE agents, or through double-carbapenem therapy (DCT). Older antibiotics such as minocycline, doxycycline, trimethoprim/sulfamethoxazole, and chloramphenicol may be effective for some CRE isolates. Recently, novel β-lactamase inhibitor combinations have provided new therapeutic options for CRE infections. However, these new β-lactamase inhibitors are not active against all carbapenemases. Avibactam inhibits both Class A KPC and Class D OXA-48, while vaborbactam and relebactam inhibit only Class A KPC. Other new agents, such as Plazomicin and Eravacycline were approved by the FDA in 2018 against MDR-Enterobacteriaceae. Cefiderocol, approved by FDA in 2019, is the first siderophore antibiotic indicated for treating infections caused by susceptible Gram-negative microorganisms.

Carbapenem-resistant Enterobacteriaceae Infection: Epidemiology

The Carbapenem-resistant Enterobacteriaceae Infection epidemiology division provides insights into the historical and current patient pool, along with the forecasted trend for every seven major countries. It helps recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. This part of the report also provides the diagnosed patient pool, trends, and assumptions.


Key Findings

The disease epidemiology covered in the report provides historical and forecasted Carbapenem-resistant Enterobacteriaceae Infection epidemiology segmented as Total Incident cases of Carbapenem-resistant Enterobacteriaceae Infection. The report includes the Incident scenario of Carbapenem-resistant Enterobacteriaceae Infection in the 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom), and Japan from 2018 to 2030.

Country-Wise Carbapenem-resistant Enterobacteriaceae Infection Epidemiology

The epidemiology segment also provides the Carbapenem-resistant Enterobacteriaceae Infection epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.


The total Incident population of Carbapenem-resistant Enterobacteriaceae Infection in the 7MM countries was estimated to be 22,243 cases in 2020.


As per the estimates, the United States had the largest Incidence of Carbapenem-resistant Enterobacteriaceae Infection in 2020. Among the EU5 countries, Italy had the largest Incident population of Carbapenem-resistant Enterobacteriaceae Infection with 5,234 cases, followed by France in 2020. On the other hand, Germany had the lowest Incident population of 374 cases in 2020.

Scope of the Report

  • Carbapenem-resistant Enterobacteriaceae Infection report covers a detailed overview explaining its causes, symptoms, classification, pathophysiology, diagnosis, and treatment patterns.
  • Carbapenem-resistant Enterobacteriaceae Infection Epidemiology Report and Model provide an overview of the risk factors and global Carbapenem-resistant Enterobacteriaceae Infection trends in the seven major markets (7MM: US, France, Germany, Italy, Spain, UK, and Japan).
  • The report provides insight into the historical and forecasted patient pool of Carbapenem-resistant Enterobacteriaceae Infection in seven major markets covering the United States, EU5 (Germany, Spain, France, Italy, UK), and Japan
  • The report helps recognize the growth opportunities in the 7MM concerning the patient population.
  • The report assesses the disease risk and burden and highlights the unmet needs of Carbapenem-resistant Enterobacteriaceae Infection.
  • The report provides the segmentation of the Carbapenem-resistant Enterobacteriaceae Infection epidemiology by Incident cases of Carbapenem-resistant Enterobacteriaceae Infection in the 7MM.

Report Highlights

  • 10-year Forecast of Carbapenem-resistant Enterobacteriaceae Infection epidemiology
  • 7MM Coverage
  • Incident Cases of Carbapenem-resistant Enterobacteriaceae Infection

KOL Views

We interview KOLs and obtain SME’s opinion through primary research to fill the data gaps and validate our secondary research. The opinion helps understand the total patient population and current treatment pattern. This will support the clients in potential upcoming novel treatment by identifying the overall scenario of the indications.

Key Questions Answered

  • What will be the growth opportunities in the 7MM for the patient population pertaining to Carbapenem-resistant Enterobacteriaceae Infection?
  • What are the key findings pertaining to the Carbapenem-resistant Enterobacteriaceae Infection epidemiology across 7MM, and which country will have the highest number of patients during the forecast period (2018–2030)?
  • What would be the total number of patients with Carbapenem-resistant Enterobacteriaceae Infection across the 7MM during the forecast period (2018–2030)?
  • Among the EU5 countries, which country will have the highest number of patients during the forecast period (2018–2030)?
  • At what CAGR the patient population is expected to grow in 7MM during the forecast period (2018–2030)?
  • What are the disease risk, burdens, and unmet needs of Carbapenem-resistant Enterobacteriaceae Infection?
  • What are the currently available treatments for Carbapenem-resistant Enterobacteriaceae Infection?

Reasons to buy

Carbapenem-resistant Enterobacteriaceae Infection Epidemiology report will allow the user to:

  • Develop business strategies by understanding the trends shaping and driving the global Carbapenem-resistant Enterobacteriaceae Infection market.
  • Quantify patient populations in the global Carbapenem-resistant Enterobacteriaceae Infection market to improve product design, pricing, and launch plans
  • Understand the magnitude of the Carbapenem-resistant Enterobacteriaceae Infection population by its Incident cases.
  • The Carbapenem-resistant Enterobacteriaceae Infection epidemiology report and model were written and developed by Masters and PhD level epidemiologists.
  • The Carbapenem-resistant Enterobacteriaceae Infection Epidemiology Model developed by DelveInsight is easy to navigate, interactive with dashboards, and epidemiology based on transparent and consistent methodologies. Moreover, the model supports data presented in the report and showcases disease trends over a 10-year forecast period using reputable sources.

Key Assessments

  • Patient Segmentation
  • Disease Risk and Burden
  • Risk of disease by the segmentation
  • Factors driving growth in a specific patient population

1. Key Insights

2. Report Introduction

3. CRE Infections Market Overview at a Glance

3.1. Market Share (%) Distribution of CRE Infections in 2018

3.2. Market Share (%) Distribution of CRE Infections in 2030

4. Executive Summary of Carbapenem-resistant Enterobacteriaceae

5. Disease Background and Overview

5.1. Introduction

5.2. Enterobacteriaceae

5.3. Classification of Carbapenem-resistant Enterobacteriaceae

5.4. Risk and Spread of CRE Infection

5.5. Mechanism of Drug Resistance

5.6. Symptoms

5.7. Diagnosis

5.8. Treatment for CRE Infections

5.9. Guidelines

6. Organizations contributing toward the fight against CRE Infections

7. Patient Journey

8. Case Study

9. Epidemiology and Patient Population

9.1. Key Findings

9.2. Epidemiology of CRE Infections

9.3. 7MM Total Incident Cases of CRE

9.4. The United States

9.4.1. Total Incident Cases of CRE in the United States

9.5. EU5

9.5.1. Germany

9.5.1.1. Total Incident Cases of CRE in Germany

9.5.2. France

9.5.2.1. Total Incident Cases of CRE in France

9.5.3. Italy

9.5.3.1. Total Incident Cases of CRE in Italy

9.5.4. Spain

9.5.4.1. Total Incident Cases of CRE in Spain

9.5.5. United Kingdom

9.5.5.1. Total Incident Cases of CRE in United Kingdom

9.6. Japan

9.6.1. Total Incident Cases of CRE in Japan

10. Appendix

10.1. Bibliography

11. Report Methodology

12. DelveInsight Capabilities

13. Disclaimer

14. About DelveInsight

List of Table

Table 1: Summary of Carbapenem-resistant Enterobacteriaceae Epidemiology (2018–2030)

Table 2: Some of the more common clinically important genera of the family Enterobacteriaceae

Table 3: Most common genera of Enterobacteriaceae causing opportunistic infections in humans

Table 4: Molecular classification scheme of carbapenemases

Table 5: Currently available antimicrobial agents and their recommended doses for treatment of CRE infections

Table 6: Organizations contributing toward the fight against CRE Infections

Table 7: Total Incident Cases of CRE in 7MM (2018–2030)

Table 8: Total Incident Cases of CRE in the United States (2018–2030)

Table 9: Total Incident Cases of CRE in Germany (2018–2030)

Table 10: Total Incident Cases of CRE in France (2018–2030)

Table 11: Total Incident Cases of CRE in Italy (2018–2030)

Table 12: Total Incident Cases of CRE in Spain (2018–2030)

Table 13: Total Incident Cases of CRE in the United Kingdom (2018–2030)

Table 14: Total Incident Cases of CRE in Japan (2018–2030)

List of Figures

Figure 1: Characteristics of members of Enterobacteriaceae family

Figure 2: Classification of CRE based on different mechanisms

Figure 3: Risk and spread of CRE Infection

Figure 4: Major mechanisms of antimicrobial resistance, including carbapenem resistance, in Enterobacteriaceae

Figure 5: Mechanism of carbapenem resistance in Enterobacteriaceae

Figure 6: Symptoms of CRE Infection

Figure 7: Flowchart for assessment of carriage of Carbapenem-resistant Enterobacteriaceae in patients being admitted to healthcare settings by European CDC

Figure 8: CRE Treatment options

Figure 9: Facility Approach to Evaluation of Newly Recognized CP-CRE Colonized or Infected Patients by Centers for Disease Control and Prevention

Figure 10: Total Incident Cases of CRE in 7MM (2018–2030)

Figure 11: Total Incident Cases of CRE in the United States (2018–2030)

Figure 12: Total Incident Cases of CRE in Germany (2018–2030)

Figure 13: Total Incident Cases of CRE in France (2018–2030)

Figure 14: Total Incident Cases of CRE in Italy (2018–2030)

Figure 15: Total Incident Cases of CRE in Spain (2018–2030)

Figure 16: Total Incident Cases of CRE in the United Kingdom (2018–2030)

Figure 17: Total Incident Cases of CRE in Japan (2018–2030)

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