Mapping the trajectory of antibiotic resistance from ESBL-producing to carbapenem-resistant Enterobacteriaceae: A bibliometric study from 2000 to 2025

Background: Antibiotic resistance in Gram-negative bacteria, particularly Carbapenem-Resistant Enterobacteriaceae (CRE), is a major global health threat. The increasing prevalence of resistance mechanisms, including ESBL and carbapenemases, necessitates systematically analysing research trends. Objective: This study aims to map global research trends on Enterobacteriaceae resistance, focusing on geographical distribution, institutional contributions, and thematic developments. Method: A bibliometric analysis of 649 publications from PubMed (2000–2025) was conducted using VOSviewer to examine international collaborations, citation networks, and keyword co-occurrences. Result: The United States (134 publications, 20.65%) was the most productive country, followed by China, France, and the UK. A total of 168 institutions, 194 journals, and 3,417 authors contributed to this field. Keyword analysis identified “Enterobacteriaceae” and “ESBL” as dominant terms, reflecting the focus on beta-lactam resistance. Conclusion: Research on Enterobacteriaceae resistance is globally extensive, with major contributions from leading countries and institutions. The findings underscore the urgency of strengthening antimicrobial resistance surveillance, infection control, and novel therapeutic strategies.