Carbapenem-resistant Enterobacterales in companion animals are an emerging One Health threat.
Granick JL, Fellman CL, Curren EJ, Funk M, James A, Kollmann L, KuKanich K, McDermott D, Stull JW, Surendran-Nair M, Wagner R, Alroy KA, Beaudoin AL, DeStefano I, Diaz-Campos D, Frey E, King C, Louis S, Stapleton GS, Cole SD · Journal of the American Veterinary Medical Association · 19 August 2026
Veterinary professionals must prioritize CRE surveillance, stewardship, and strict infection control to prevent zoonotic spread.
Carbapenem-resistant Enterobacterales (CRE) represent an escalating One Health threat affecting companion animals, humans, and the shared environment. Although carbapenems are not approved for veterinary use, extralabel prescribing in dogs and cats occurs, and CRE detections in US companion animals have increased recently. While overall prevalence in companion animals is estimated to be low, veterinary hospital outbreaks demonstrate that CRE can be transmitted within clinical settings, persist in the environment, and cause significant operational disruption. Bidirectional exchange of CRE between companion animals and people has been documented, underscoring zoonotic and reverse-zoonotic transmission risks. Critical knowledge gaps remain, including underestimation of true prevalence due to infrequent testing and underreporting, inconsistent access to resistance mechanism characterization, limited data on colonization dynamics, and insufficient characterization of acquisition risk factors. Antimicrobial stewardship, robust surveillance, and coordinated One Health preparedness are essential to mitigate CRE spread. This review provides veterinary professionals with a practical overview of CRE epidemiology, resistance mechanisms, diagnostic considerations, therapeutic limitations, and infection prevention and control (IPC) strategies. A companion article in AJVR (forthcoming 2026) further reviews carbapenemase-producing CRE in companion animals, identifies ongoing knowledge gaps, and outlines research priorities. Veterinary teams should prioritize CRE awareness, appropriate culture and sensitivity testing, and rigorous IPC protocols in hospital settings.
This summary was distilled by AI and may occasionally misinterpret data. Confirm critical details with the primary literature before clinical application.