September 24, 2025
James Archer/CDC
Drug-resistant infections caused by NDM-CRE bacteria have spiked by 460% in recent years, the CDC warns. Above, a computer-generated illustration of CRE bacteria.
Infections caused by a drug-resistant bacteria once considered uncommon are surging in the United States, a new Centers for Disease Control and Prevention study finds.
These so-called "nightmare" bacteria, formally known as NDM-CRE bacteria, have developed resistance to most antibiotics, including the last-resort carbapenem antibiotics. This makes infections incredibly hard to treat and potentially deadly.
Bloodstream infections, urinary tract infections, wound infections and pneumonia primarily due to NDM-CRE bacteria spiked 460% between 2019 and 2023, according to the CDC report, which was published in the journal Annals of Internal Medicine.
"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 at the CDC said in a news release. "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."
The NDM-CRE bacteria are a subtype of bacteria known as carbapenem-resistant Enterobacterales (CRE) that have an enzyme (NDM) that makes them resistant to "nearly all available antibiotics," the CDC said. People with these infections have few treatment options.
"Because NDM-CRE has historically been uncommon in the United States, healthcare providers might not suspect it when treating patients with CRE infections," the CDC said. "This can lead them to pick a treatment that is not effective."
Bacteria and other pathogens evolve over time and can develop resistance to medications that have formerly been effective at combatting them. The increased use and misuse of antibiotics in humans, animals and agriculture are the primary cause of so-called "superbugs" that have become drug-resistant, according to the Cleveland Clinic.
The CDC issued its first report about the threat of antibiotic resistance in 2013, spurring coordinated action among U.S. federal health agencies.
Worldwide, anti-microbial resistance caused 1.27 million deaths and contributed to nearly 5 million deaths in 2019, alone, according to the World Health Organization.
In the United States, deaths caused by antimicrobial-resistant infections declined 18% overall and by nearly 30% in hospitals between 2012 and 2017. But the strain that the COVID-19 pandemic put on health care providers, and the increased use of antimicrobial agents including hand sanitizer, disinfectants and medications, caused a jump in drug-resistant infections, according to a 2022 CDC report.
That report noted the CRE bacteria caused 12,700 infections and 1,100 deaths in the U.S. in 2020.
The surge in infections highlighted in the new report is partly due to the fact that many health care settings do not yet have ways to rapidly diagnose NDM-CRE infections or the presence of the germs in people who are not having symptoms. This delays treatment and increases transmission, the CDC said.
The increase in infections noted in the report is probably an underestimate, since the researchers did not have data for Texas, New York, California and Florida, according to the Associated Press
