Global trends and future directions on carbapenem-resistant Enterobacteriaceae (CRE) research: A comprehensive bibliometric analysis (2020-2024).

The increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) poses a significant threat to public health. CRE, particularly Klebsiella pneumoniae, is associated with high morbidity and mortality owing to limited treatment options. This study identifies current research trends, major topics, and future directions in the scientific field of CRE. We systematically retrieved publications from the Web of Science database starting from 2020 to January 07, 2024. Using bibliometric tools such as VOSviewer, CiteSpace, and InCites, we analyzed publication counts, citation analysis, co-authorship, keyword co-occurrence, and thematic development to map the landscape and collaborative networks in the field. The search included keywords such as "carbapenem-resistant Enterobacteriaceae," "carbapenemase-producing Enterobacteriaceae," "carbapenemase-producing Klebsiella pneumoniae," and "Klebsiella pneumoniae carbapenemase." We reviewed 1946 articles. The largest contributors to the field were China, the United States, and Italy. This study highlights the significant increase in CRE-related publications, particularly in the context of hospital-acquired infections, antimicrobial resistance mechanisms, and novel therapeutic approaches. Keyword trend analysis revealed epidemiology, molecular biology, infection control, and public health implications, signaling a shift towards the broader impact of CRE in healthcare settings. This bibliometric analysis maps the current research landscape and identifies key areas for further research. Continued progress is essential to develop strategies to combat antimicrobial resistance and to improve patient outcomes.