Objective To evaluate the effectiveness of active screening in improving the detection rate of carbape-nem-resistant Enterobacterales (CRE) in the intensive care units (ICUs). Methods From July 2023 to June 2024, active screening of rectal swab CRE was conducted on ICU patients in 10 hospitals. ICU patients who underwent active screening from July 2023 to June 2024 were selected as the study group, while those who did not undergo active screening from July 2022 to June 2023 were selected as the control group. Difference in CRE detection rates between the two groups of patients was compared. Results A total of 7 803 ICU patients were included in the study group, 744 CRE strains were detected, with a detection rate of 9.53%, out of which 304 CRE strains were detected through routine detection (detection rate 3.90%), 3 707 patients underwent active screen, 440 CRE strains were detected (detection rate 11.87%). 7 561 ICU patients were included in the control group, out of which 250 CRE strains were detected through routine detection, with a detection rate of 3.31%. There was a statistically significant difference in the overall detection rate of CRE between two groups of patients (χ²=246.18, P<0.001). In the study group, CRE detection rate of active screening (11.87%) was higher than that of routine detection (3.90%), with statistically significant difference (χ²=264.26, P<0.001). A total of 17 CRE strains were detected from the study group. The proportions of Klebsiella pneumoniae (80.92% vs 73.41%) and Serratia marcescens (2.30% vs 0.23%) in the routine detection group were both higher than in the active screening group, while the proportion of Escherichia coli in the routine detection group was lower (8.22% vs 19.55%), all with statistically significant differences (all P<0.05). Conclusion The prevalence of CRE in ICUs is relatively high, with a wide range of bacterial species. Active screening can improve the detection rate of CRE.