{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T22:26:16Z","timestamp":1787178376485,"version":"build-2736575974"},"reference-count":78,"publisher":"American Veterinary Medical Association (AVMA)","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2026,8,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Carbapenem-resistant Enterobacterales (CRE) are an emerging, multidrug-resistant threat to human and animal health. Emergence is driven by antimicrobial use and multidirectional transmission pathways between humans, animals, and the environment. Carbapenems are essential drugs for treatment of multidrug-resistant infections in humans and, although not approved for veterinary use, are infrequently prescribed in dogs and cats in an extralabel manner. In the US, CRE detections in companion animals have recently increased. While prevalence of CRE in US companion animals is estimated to be low, outbreaks in veterinary hospitals demonstrate that CRE can be transmitted within animal healthcare settings, persist in the environment, and cause operational disruption. Exchange of CRE between companion animals and people has been documented. There are several important knowledge gaps about CRE in companion animals, including (1) uncertainties in true prevalence due to infrequent testing and underreporting; (2) lack of understanding of carbapenem resistance mechanisms because of inconsistent access to testing; (3) limited data on colonization dynamics; and (4) lack of information characterizing risk factors for acquisition. A coordinated One Health approach for surveillance and preparedness is essential to identify, prevent, and contain CRE. Here we provide veterinary professionals with a comprehensive, practical overview of CRE epidemiology, mechanisms of resistance, diagnostic considerations, therapeutic limitations, and infection prevention and control (IPC) practices. The companion\n                    <jats:italic>Currents in One Health<\/jats:italic>\n                    article by Frey et al,\n                    <jats:italic>AJVR<\/jats:italic>\n                    , forthcoming 2026, reviews the current understanding of carbapenemase-producing CRE in companion animals; identifies gaps in epidemiology, diagnostics, and infection control; and outlines priorities for future research.\n                  <\/jats:p>","DOI":"10.2460\/javma.26.06.0512","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T22:19:53Z","timestamp":1787177993000},"page":"1-11","source":"Crossref","is-referenced-by-count":0,"title":["Carbapenem-resistant Enterobacterales in companion animals are an emerging One Health threat"],"prefix":"10.2460","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8330-3848","authenticated-orcid":true,"given":"Jennifer L.","family":"Granick","sequence":"first","affiliation":[{"name":"Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4799-3372","authenticated-orcid":true,"given":"Claire L.","family":"Fellman","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily J.","family":"Curren","sequence":"additional","affiliation":[{"name":"Wyoming Department of Health, Cheyenne, WY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Funk","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0556-4369","authenticated-orcid":true,"given":"Allison","family":"James","sequence":"additional","affiliation":[{"name":"CDC, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Kollmann","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"KuKanich","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darby","family":"McDermott","sequence":"additional","affiliation":[{"name":"New Jersey Department of Health, Trenton, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9028-8153","authenticated-orcid":true,"given":"Jason W.","family":"Stull","sequence":"additional","affiliation":[{"name":"Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Surendran-Nair","sequence":"additional","affiliation":[{"name":"Antech Diagnostics, Fountain Valley, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen A.","family":"Alroy","sequence":"additional","affiliation":[{"name":"New York City Department of Health and Mental Hygiene, Queens, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda L.","family":"Beaudoin","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3634-9971","authenticated-orcid":true,"given":"Ian","family":"DeStefano","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6749-4218","authenticated-orcid":true,"given":"Dubra","family":"Diaz-Campos","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1773-525X","authenticated-orcid":true,"given":"Erin","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christy","family":"King","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souci","family":"Louis","sequence":"additional","affiliation":[{"name":"CDC, Atlanta, GA"},{"name":"US Public Health Service, Rockville, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Sean","family":"Stapleton","sequence":"additional","affiliation":[{"name":"CDC, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2681-0082","authenticated-orcid":true,"given":"Stephen D.","family":"Cole","sequence":"additional","affiliation":[{"name":"Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"10459","key":"ref1","series-title":"Lancet","first-page":"1199","article-title":"GBD 2021 Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050","volume":"404","author":"Naghavi M","year":"2024","unstructured":"Naghavi M, Vollset SE, Ikuta KS, ; GBD 2021 Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050. Lancet. 2024;404(10459):1199\u20131226. doi:10.1016\/S0140-6736(24)01867-1"},{"key":"ref2","series-title":"Antibiotic Resistance Threats in the United States, 2019","year":"2019","unstructured":"US CDC. Antibiotic Resistance Threats in the United States, 2019. CDC; 2019. doi:10.15620\/cdc:82532"},{"key":"ref3","series-title":"Front Public Health","first-page":"1161950","article-title":"Epidemiology of companion animal AMR in the United States of America: filling a gap in the One Health approach","volume":"11","author":"Sobkowich KE","year":"2023","unstructured":"Sobkowich KE, Weese JS, Poljak Z, Plum A, Szlosek D, Bernardo TM. Epidemiology of companion animal AMR in the United States of America: filling a gap in the One Health approach. Front Public Health. 2023;11:1161950. doi:10.3389\/fpubh.2023.1161950"},{"issue":"12","key":"ref4","series-title":"Animals (Basel)","first-page":"1708","article-title":"Antimicrobial resistance in European companion animals practice: a One Health approach","volume":"15","author":"Monteiro HIG","year":"2025","unstructured":"Monteiro HIG, Silva V, de Sousa T,  Antimicrobial resistance in European companion animals practice: a One Health approach. Animals (Basel). 2025;15(12):1708. doi:10.3390\/ani15121708"},{"key":"ref5","series-title":"One Health","first-page":"100593","article-title":"Evidence for the transmission of antimicrobial resistant bacteria between humans and companion animals: a scoping review","volume":"17","author":"Jin M","year":"2023","unstructured":"Jin M, Osman M, Green BA,  Evidence for the transmission of antimicrobial resistant bacteria between humans and companion animals: a scoping review. One Health. 2023;17:100593. doi:10.1016\/j.onehlt.2023.100593"},{"issue":"1","key":"ref6","series-title":"Clin Microbiol Rev","first-page":"e0014622","article-title":"Companions in antimicrobial resistance: examining transmission of common antimicrobial-resistant organisms between people and their dogs, cats, and horses","volume":"38","author":"Caddey B","year":"2025","unstructured":"Caddey B, Fisher S, Barkema HW, Nobrega DB. Companions in antimicrobial resistance: examining transmission of common antimicrobial-resistant organisms between people and their dogs, cats, and horses. Clin Microbiol Rev. 2025;38(1):e0014622. doi:10.1128\/cmr.00146-22"},{"key":"ref7","series-title":"Front Cell Infect Microbiol","first-page":"823684","article-title":"Global threat of carbapenem-resistant gram-negative bacteria","volume":"12","author":"Jean SS","year":"2022","unstructured":"Jean SS, Harnod D, Hsueh PR. Global threat of carbapenem-resistant gram-negative bacteria. 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J Am Vet Med Assoc. 2025;263(7):1\u201310. doi:10.2460\/javma.24.09.0572"},{"issue":"5","key":"ref24","series-title":"J Vet Intern Med","first-page":"2642","article-title":"Prevalence and distribution of carbapenem-resistant Enterobacterales in companion animals: a nationwide study in the United States using commercial laboratory data","volume":"38","author":"Sobkowich K","year":"2024","unstructured":"Sobkowich K, Poljak Z, Weese JS, Plum A, Szlosek D, Bernardo TM. Prevalence and distribution of carbapenem-resistant Enterobacterales in companion animals: a nationwide study in the United States using commercial laboratory data. 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Open Forum Infect Dis. 2025;12(10):ofaf613. doi:10.1093\/ofid\/ofaf613"},{"issue":"5","key":"ref26","series-title":"Zoonoses Public Health","first-page":"538","article-title":"Prevalence and molecular epidemiology of carbapenemase-producing Enterobacterales isolated from dog and cat faeces submitted to veterinary laboratories in the USA","volume":"71","author":"Dietrich J","year":"2024","unstructured":"Dietrich J, LeCuyer TE, Hendrix GK,  Prevalence and molecular epidemiology of carbapenemase-producing Enterobacterales isolated from dog and cat faeces submitted to veterinary laboratories in the USA. Zoonoses Public Health. 2024;71(5):538\u2013548. doi:10.1111\/zph.13144"},{"issue":"3","key":"ref27","series-title":"J Clin Microbiol","first-page":"e0215421","article-title":"A survey of current activities and technologies used to detect carbapenem resistance in bacteria isolated from companion animals at veterinary diagnostic laboratories\u2014United States, 2020","volume":"60","author":"Waltenburg MA","year":"2022","unstructured":"Waltenburg MA, Shugart A, Loy JD,  A survey of current activities and technologies used to detect carbapenem resistance in bacteria isolated from companion animals at veterinary diagnostic laboratories\u2014United States, 2020. 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Emerg Infect Dis. 2026;32(3):341\u2013348. doi:10.3201\/eid3203.251458"},{"issue":"6","key":"ref29","series-title":"Emerg Infect Dis","first-page":"1","article-title":"One Health approach for reporting veterinary carbapenem-resistant Enterobacterales and other bacteria of public health concern","volume":"29","author":"KuKanich K","year":"2023","unstructured":"KuKanich K, Burklund A, McGaughey R,  One Health approach for reporting veterinary carbapenem-resistant Enterobacterales and other bacteria of public health concern. Emerg Infect Dis. 2023;29(6):1\u20139. doi:10.3201\/eid2906.221648"},{"issue":"10","key":"ref30","series-title":"J Antimicrob Chemother","first-page":"2754","article-title":"Enterobacterales high-risk clones and plasmids spreading blaESBL\/AmpC and blaOXA-48 genes within and between hospitalized dogs and their environment","volume":"77","author":"Haenni M","year":"2022","unstructured":"Haenni M, Boulouis HJ, Lagr\u00e9e AC,  Enterobacterales high-risk clones and plasmids spreading blaESBL\/AmpC and blaOXA-48 genes within and between hospitalized dogs and their environment. J Antimicrob Chemother. 2022;77(10):2754\u20132762. doi:10.1093\/jac\/dkac268"},{"issue":"23","key":"ref31","series-title":"Animals (Basel)","first-page":"3359","article-title":"Fecal carriage and risk factors associated with extended-spectrum \u03b2-lactamase-\/AmpC-\/carbapenemase-producing Escherichia coli in dogs from Italy","volume":"14","author":"Facchin A","year":"2024","unstructured":"Facchin A, Ratti G, Filipe J,  Fecal carriage and risk factors associated with extended-spectrum \u03b2-lactamase-\/AmpC-\/carbapenemase-producing Escherichia coli in dogs from Italy. Animals (Basel). 2024;14(23):3359. doi:10.3390\/ani14233359"},{"issue":"3","key":"ref32","series-title":"Am J Vet Res","first-page":"ajvr","article-title":"\u03b2-Lactam and metronidazole administration are risk factors for carbapenemase-producing Enterobacterales acquisition in hospitalized dogs","volume":"87","author":"Chien S","year":"2025","unstructured":"Chien S, Cole SD, Dietrich J, Redding LE, Hsieh E. \u03b2-Lactam and metronidazole administration are risk factors for carbapenemase-producing Enterobacterales acquisition in hospitalized dogs. Am J Vet Res. 2025;87(3):ajvr.25.09.0344. doi:10.2460\/ajvr.25.09.0344"},{"issue":"3","key":"ref33","series-title":"J Am Anim Hosp Assoc","first-page":"101","article-title":"Risk factors for the acquisition of a blaNDM-5 carbapenem-resistant Escherichia coli in a veterinary hospital","volume":"57","author":"Lavigne SH","year":"2021","unstructured":"Lavigne SH, Cole SD, Daidone C, Rankin SC. Risk factors for the acquisition of a blaNDM-5 carbapenem-resistant Escherichia coli in a veterinary hospital. J Am Anim Hosp Assoc. 2021;57(3):101\u2013105. doi:10.5326\/JAAHA-MS-7105"},{"issue":"2","key":"ref34","series-title":"Antibiotics (Basel)","first-page":"213","article-title":"Massive spread of OXA-48 carbapenemase-producing Enterobacteriaceae in the environment of a Swiss companion animal clinic","volume":"11","author":"Schmitt K","year":"2022","unstructured":"Schmitt K, Biggel M, Stephan R, Willi B. Massive spread of OXA-48 carbapenemase-producing Enterobacteriaceae in the environment of a Swiss companion animal clinic. Antibiotics (Basel). 2022;11(2):213. doi:10.3390\/antibiotics11020213"},{"issue":"1","key":"ref35","series-title":"Antimicrob Resist Infect Control","first-page":"93","article-title":"Poor infection prevention and control standards are associated with environmental contamination with carbapenemase-producing Enterobacterales and other multidrug-resistant bacteria in Swiss companion animal clinics","volume":"9","author":"Schmidt JS","year":"2020","unstructured":"Schmidt JS, Kuster SP, Nigg A,  Poor infection prevention and control standards are associated with environmental contamination with carbapenemase-producing Enterobacterales and other multidrug-resistant bacteria in Swiss companion animal clinics. Antimicrob Resist Infect Control. 2020;9(1):93. doi:10.1186\/s13756-020-00742-5"},{"issue":"1","key":"ref36","series-title":"J Vet Intern Med","first-page":"aalaf023","article-title":"Management of carbapenem-resistant Enterobacterales in a veterinary hospital environment utilizing surveillance with infection control and prevention measures","volume":"40","author":"King C","year":"2026","unstructured":"King C, Diaz-Campos D, Mollenkopf D,  Management of carbapenem-resistant Enterobacterales in a veterinary hospital environment utilizing surveillance with infection control and prevention measures. 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