Perspective Article Open Access

Carbapenem‑Resistant Gram‑Negative Bacteria: A Global Perspective on Emergence, Challenges, and Future Directions

Abstract

Carbapenem‑resistant Gram‑negative bacteria (CRGNB) have emerged as one of the most critical threats to global health, undermining the efficacy of last‑line β‑lactam antibiotics and contributing to increased morbidity, mortality, and healthcare costs. These organisms include carbapenem‑resistant Enterobacterales (CRE), Pseudomonas aeruginosa (CRPA), and Acinetobacter baumannii (CRAB), all of which have demonstrated rapid geographic dissemination and complex resistance mechanisms. Resistance arises through enzymatic degradation via carbapenemases, efflux pump overexpression, porin mutations, and mobile genetic elements facilitating horizontal gene transfer. CRGNB infections are associated with limited treatment options, often requiring toxic or less effective drugs, and their prevalence highlights gaps in antimicrobial stewardship, diagnostics, infection control, and environmental reservoirs of resistance. This perspective explores the epidemiology, underlying mechanisms, clinical implications, diagnostic challenges, therapeutic strategies, and future research priorities. To address this growing threat, a coordinated global response integrating novel diagnostics, stewardship programs, innovative therapeutics, and environmental surveillance is essential.

Priya Nair

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