Insight into the Antibiotic Susceptibility Algorithm Procedures for Detecting Carbapenem-Resistant Enterobacter Cloacae

Abstract

The sudden increase in the predominance and clinical impact of infection caused by carbapenem resistance Enterobacter cloacae (CR-ECL) is a global health concern. CR-ECL is notably problematic when identified in the clinical microbiology laboratory. Due to CR-ECL's intrinsic resistance to most cephalosporin and carbapenem and their ability to spread and colonize patients in healthcare settings, identifying and preventing the transmission of these organisms is a significant public health initiative, and coordinated international efforts are needed. Following established antibiotic susceptibility algorithms ensures a systematic and comprehensive assessment of bacterial resistance patterns. This approach helps identify potential resistance mechanisms and guide effective treatment strategies. The algorithm approach considers clinical factors such as patient history, site of infection, and local resistance patterns, enhancing the relevance and applicability of susceptibility testing results to individual patient management. Importantly, continuously monitoring CR-ECL antibiotic resistance patterns and surveillance of emerging resistance mechanisms is essential to adapting and refining antibiotic susceptibility algorithms to evolving clinical needs. This review highlights our current understanding of CR-ECL, emphasizing their epidemiology, detection, treatment, and control.