Global Trends and Reporting Dynamics in Whole-Genome Sequencing Studies of Carbapenemase-Producing Enterobacterales: A Systematic Review with Descriptive Synthesis, 2017–June 2026

The WHO ranks carbapenem-resistant Enterobacterales, including carbapenemase-producing Enterobacterales (CPE), among its critical-priority pathogens. This systematic review synthesizes a decade of the published global whole-genome sequencing (WGS) studies to characterize global reporting patterns in the genomic literature on CPE. Four databases (MEDLINE/PubMed, Scopus, Web of Science Core Collection, and Embase) were searched for English-language research articles on WGS studies of CPE published between 1 January 2017 and June. Carbapenemase genes were summarized at harmonized family and allele level as study-level reporting frequencies; no prevalence was pooled. Geographical concentration was quantified with the Gini coefficient and quality with the JBI checklist. Fifty-eight studies from 22 countries and territories across six WHO regions met the eligibility criteria. At family level, the most frequently reported were KPC (67.2%), NDM (62.1%), and OXA-48-like (39.7%). IncX3 and IncFII were the most reported replicons (tied, 42.0%). The evidence was geographically concentrated (Gini 0.519, 95% bootstrap CI 0.42–0.64; small-sample-corrected 0.622, 95% CI 0.50–0.77; Western Pacific 51.9% of mapped studies, Africa 1.9%). In the present review the most frequently reported determinants were blaKPC-2 and the NDM family, set against markedly uneven geographic representation. Because these are reporting patterns rather than prevalence, equitable, standardized genomic surveillance—anchored in GLASS—is needed.