Carbapenem-Resistant Enterobacteriaceae: Microbiome Influence and Infectious Disease Dynamics

Carbapenem-resistant Enterobacteriaceae (CRE) are among the most challenging pathogens in contemporary clinical practice, contributing to severe infections with high morbidity and mortality. The resistance of these pathogens, primarily driven by the production of carbapenemases, limits treatment options and complicates management strategies. A growing body of evidence suggests that the human microbiome, particularly the gut microbiota, plays a crucial role in the emergence and persistence of CRE. Disruption of the microbiome, caused by factors such as antibiotic use, diet, and disease, can create ecological niches that favor the colonization of resistant pathogens. The microbiome's influence extends beyond mere colonization; it also modulates host immune responses, potentially enhancing or inhibiting infection severity and resistance development.
In addition to these microbiome-related factors, the dynamic evolution of CRE presents a complex challenge. The resistance mechanisms of CRE are not static but evolve through genetic mutations, horizontal gene transfer, and selective pressures within the host environment. These dynamics contribute to the spread of resistance and the persistence of CRE in hospital settings and the community. Understanding how the microbiome interacts with these evolutionary processes, and how these interactions influence the transmission and pathogenicity of CRE, is essential for developing effective therapeutic and preventive strategies.

This Research Topic will explore the intricate relationship between the microbiome and the evolving landscape of Carbapenem-resistant Enterobacteriaceae infections, providing insights into novel avenues for intervention.

This Research Topic invites contributions focused on the intersection of carbapenem-resistant Enterobacteriaceae (CRE), the microbiome, and infectious disease. Authors are encouraged to address the following themes:
1) New mechanisms of resistance to carbapenems, colistin, and tigecycline in CRE
2) Genomic features and epidemiology of CRE isolated from patients or environmental sources
3) The role of the gut microbiome in the colonization and persistence of carbapenem-resistant Enterobacteriaceae
4) Genetic and ecological evolution of carbapenem resistance in Enterobacteriaceae