In the United States, infection rates are climbing due to a concerning bacteria that exhibits resistance to some of the most powerful antibiotics available. This situation is prompting infectious disease specialists to express worries about managing the growing threat.
This week, the Centers for Disease Control and Prevention revealed that from 2019 to 2023, cases of infection from a bacteria known as NDM-producing carbapenem-resistant Enterobacterales (NDM-CRE) have surged by over 460% in the U.S.
NDM-CRE is characterized by a unique gene that allows it to neutralize strong antibiotics, making typical treatments ineffective, as explained by Shruti Gohil, an associate professor of infectious diseases at UC Irvine School of Medicine.
“These ‘superbug’ bacteria are particularly challenging to treat since they resist our strongest antibiotics,” Gohil stated.
The CDC’s previous report, released in 2022, indicated that in 2020 there were around 12,700 infections and 1,100 fatalities attributed to this type of drug-resistant bacteria in the U.S.
While the CDC did not pinpoint a specific cause for the recent increase, Neha Nanda, a medical director at USC’s Keck Medicine, mentioned a possible link with the use of antibiotics during the early pandemic phase for COVID-19 patients.
Health officials caution that NDM-CRE has not traditionally been prominent in the U.S., which may lead healthcare providers to overlook it when diagnosing patients with bacterial infections.
The escalation of these infections poses further risks of increased cases and fatalities related to NDM-CRE, as per the CDC report.
This marks the second time the CDC has published findings indicating a rise in bacteria-related illnesses, with the most recent report detailing cases in New York City between 2019 and 2024.
Available treatment for NDM-CRE?
According to experts, individuals infected with NDM-CRE generally don’t show symptoms until they develop an infection, which can present in various forms. NDM-CRE infections have the potential to cause pneumonia, bloodstream infections, urinary tract infections, and wound infections.
Symptoms can range from fever and chills to cough and shortness of breath if the lungs are affected. There might also be pain or blood during urination if the urinary system is involved.
As the bacteria resist most antibiotics, options for treatment become quite limited, leading to longer recovery times and a heightened risk of severe complications or death, Gohil noted.
In addition to treatment difficulties, health officials are also concerned about the bacteria’s ability to spread and survive on contaminated surfaces.
While tests for NDM-CRE are available, most individuals won’t need testing unless they fall into higher risk categories, experts suggest.
Those at increased risk include people who have spent time in hospitals—especially abroad—have received repeated courses of antibiotics, have undergone invasive procedures, or have had close contact with someone confirmed to have NDM-CRE, according to Gohil.
Testing can also be complicated since many healthcare facilities lack rapid detection capabilities, even for individuals who are not symptomatic.
How to protect yourself against NDM-CRE
The overuse of strong antibiotics is a primary driver behind the rise of NDM-CRE.
“I think this could be a chance for us to shift the conversation around antibiotic expectations among patients,” Nanda commented.
She encourages patients prescribed antibiotics to ask their doctors:
- Why are you being given antibiotics? Is it truly necessary?
- What other treatment options are available? Ensure you consider all alternatives before resorting to antibiotics.
“If antibiotics are needed, then they’re needed—but it’s important to use them wisely,” she remarked.
Since NDM-CRE infections predominantly affect individuals who are quite ill, such as those in hospitals or long-term care facilities, experts advise that patients, healthcare professionals, and visitors in these environments should maintain good hand hygiene and steer clear of contaminated surfaces.
