Escherichia coli is a common commensal and pathogenic bacterium in the human microflora.As a major causative agent of enteric,septicemia,and urinary tract infections,Escherichia coli poses a huge burden on healthcare systems worldwide.In recent years,the misuse of antimicrobial agents in clinical practice has led to the emergence of carbapenem-resistant Escherichia coli(CREO),posing a serious challenge to clinical treatment.Tigecycline is considered to be one of the first-line therapies for the treatment of CREO.However,CREO can become resistant to tigecycline.The mechanisms of resistance in CREO to tigecycline include overexpression of efflux pumps,plasmid-mediated resistance genes,and gene mutations in the lipopolysaccharide core biosynthesis path way.This article reviews the resistance mechanism of CREO and explores the current alternative therapies for tigecycline-resistant CERO.
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