{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:54:31Z","timestamp":1791269671285,"version":"4.1.0"},"reference-count":105,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":277,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001796","name":"University of the Sunshine Coast","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001796","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Tropical Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Carbapenems are among the most important broad\u2010spectrum \u03b2\u2010lactam antibiotics for the treatment of severe infections caused by multi\u2013drug\u2010resistant Gram\u2010negative bacteria. However, the global emergence and dissemination of carbapenem\u2010resistant Enterobacterales (CRE), particularly carbapenemase\u2010producing Enterobacterales (CPE), have significantly compromised their clinical utility. Resistance is primarily driven by the acquisition of genes encoding carbapenemases, often in combination with porin alterations, efflux pump overexpression and AmpC hyperproduction, resulting in limited treatment options and increased morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This scoping review aimed to synthesise current evidence on the molecular mechanisms of carbapenem resistance, the classification and epidemiology of carbapenemases, advances in diagnostic approaches and emerging therapeutic strategies for CRE infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A scoping review was conducted in accordance with the PRISMA extension for Scoping Reviews (PRISMA\u2010ScR). Literature published between January 2005 and March 2026 was identified through systematic searches of PubMed\/MEDLINE, Scopus and Google Scholar. Eligible studies included original research articles, surveillance reports, systematic reviews and clinical guidelines addressing carbapenem resistance mechanisms, carbapenemase epidemiology, diagnostics or treatment strategies. Data were extracted and synthesised using a narrative and thematic approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Carbapenemase production was identified as the predominant mechanism of resistance among CRE, with KPC, NDM, OXA\u201048\u2010like, VIM and IMP enzymes driving global dissemination. Considerable geographical variation exists in carbapenemase distribution, reflecting differences in antimicrobial use, surveillance capacity and healthcare infrastructure. Advances in molecular diagnostics, including polymerase chain reaction, loop\u2010mediated isothermal amplification, whole\u2010genome sequencing and rapid immunochromatographic assays, have improved detection and surveillance. Emerging therapeutic options, particularly novel \u03b2\u2010lactam\/\u03b2\u2010lactamase inhibitor combinations and cefiderocol, have expanded treatment possibilities, although resistance to newer agents continues to emerge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CREs remain a major global public health threat. Strengthened surveillance systems, improved access to rapid diagnostics, carbapenemase\u2010directed therapeutic strategies and continued antimicrobial development are essential to limit the spread of resistance and improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jotm\/5663176","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:37:56Z","timestamp":1791268676000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanisms, Significance, Detection and Emerging Therapies for Carbapenem\u2010Resistant Enterobacterales: A Scoping Review"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7720-3111","authenticated-orcid":false,"given":"Oluchi Judith","family":"Osuala","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Microbiology and Biotechnology Madonna University  Elele Rivers 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