Improvements in knowledge and detection of carbapenemase-producing Enterobacterales transmission in companion animals will strengthen prevention across the One Health spectrum.
Frey E, Alroy KA, Beaudoin A, DeStefano I, Diaz-Campos D, Curren E, Fellman C, Funk M, Granick J, James AE, Kollmann L, KuKanich K, McDermott D, Stull JW, Surendran-Nair M, Wagner R, King C, Louis S, Stapleton GS, Cole SD · American Journal of Veterinary Research · 31 July 2026
CP-CRE outbreaks in veterinary hospitals are increasing, requiring urgent improvements in diagnostics, surveillance, and infection prevention.
Carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) represent an escalating threat in veterinary medicine, with outbreaks in veterinary hospitals increasingly documented and bidirectional transmission between companion animals and humans confirmed by epidemiologic and molecular evidence. This review highlights that while CP-CRE infections in companion animals remain relatively rare, their emergence constitutes both an animal health and a public health concern under the One Health framework. Critical knowledge gaps persist: true colonization prevalence in companion animals is unknown, longitudinal carriage dynamics are poorly characterized, and specific acquisition risk factors in veterinary hospital and community settings are insufficiently studied. Infection prevention and control (IPC) in veterinary settings faces unique structural and cultural barriers, with a lack of evidence-based, veterinary-tailored best practices. Diagnostic and surveillance infrastructure is fragmented, marked by inconsistent carbapenemase testing availability, limited mandatory reporting requirements, and inadequate outbreak detection and response capacity. The authors synthesize current clinical and molecular epidemiology, identify deficiencies in diagnostics, surveillance, and IPC implementation, and propose targeted research priorities. Practicing veterinarians are directed to a companion article in JAVMA (Granick et al., 2026) for clinical management strategies. Collectively, strengthening veterinary diagnostic capacity, standardizing carbapenemase surveillance, and developing evidence-based IPC protocols are essential to mitigating CP-CRE spread across the human-animal interface.
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