Antibiotic Resistance On The Rise In US As 'Nightmare Bacteria' Cases Spike 69%

The United States saw an alarming rise in the cases of "nightmare bacteria", with a staggering 69% increase in infections between 2019 and 2023, according to a report by the Centers for Disease Control and Prevention (CDC) published on Tuesday. These bacteria are resistant to multiple antibiotics, making them extremely challenging to treat.

The CDC report, published in the Annals of Internal Medicine, highlights a dramatic increase in bacteria called NDM-producing carbapenem-resistant Enterobacterales (NDM-CRE). The carbapenems are a class of antibiotics considered a last resort for serious infections.

The increase is largely driven by bacteria carrying the NDM (New Delhi metallo-beta-lactamase) gene, which neutralises multiple antibiotics.

Only two antibiotics are effective against these infections, and they're expensive and also require IV administration. The CDC has discussed this "nightmare bacteria" in the past few years.

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In a special report on COVID-19 published in 2022, the CDC noted that in 2020, there were approximately 12,700 infections and 1,100 deaths in the US due to CRE.

However, the rise in NDM-CRE, which is mentioned in the latest study, threatens to increase CRE infections and deaths.

According to the report, the carbapenem-resistant infections rose from 2 per 100,000 people in 2019 to over 3 per 100,000 in 2023. Meanwhile, the NDM cases jumped from 0.25 to 1.35 per 100,000, which is a 460% increase.

The CDC recorded 4,341 carbapenem-resistant bacterial infections in 29 states in 2023, with 1,831 being NDM variety.

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"This sharp rise in NDM-CRE means we face a growing threat that limits our ability to treat some of the most serious bacterial infections," Danielle Rankin, an epidemiologist in CDC's Division of Healthcare Quality Promotion, as quoted in the report.

"Selecting the right treatment has never been more complicated, so it is vitally important that healthcare providers have access to testing to help them select the proper targeted therapies."

NDM-CRE is a serious risk

It is an extremely serious risk because the infections are difficult to treat, with just a few effective treatment options. CDC says that the infections are associated with high rates of morbidity and mortality.

Without appropriate prevention and control measures, it can move through healthcare settings and into the community.

Experts even suspect the COVID-19 pandemic's surge in antibiotic use contributed to increased resistance. "We know that there was a huge surge in antibiotic use during the pandemic, so this likely is reflected in increasing drug resistance," Dr Jason Burnham, a Washington University researcher, told The New York Post in an email.

The CDC's count is likely an underestimate, as many states don't test or report cases. Notably, antibiotic resistance is a global health security concern, with varying prevalence across regions.