Infection rates linked to drug-resistant “nightmare bacteria” in the United States increased by nearly 70% from 2019 to 2023, according to a recent report from the Centers for Disease Control and Prevention (CDC). The rise is primarily attributed to bacteria that carry the NDM gene, as detailed in an article published in the Annals of Internal Medicine on March 20, 2023.
This alarming trend highlights a growing public health challenge. Only two antibiotics are effective against these infections, and they require intravenous administration, making them costly and less accessible. Researchers noted that the NDM gene, which was once associated with a limited number of patients who had received medical care abroad, is now appearing more frequently within the U.S. population. The incidence of these cases has increased more than fivefold in recent years, with the CDC reporting 4,341 cases of carbapenem-resistant bacterial infections in 2023, including 1,831 cases specifically linked to the NDM variety.
Implications for Public Health
The implications of this rise are significant. “The rise of NDMs in the U.S. is a grave danger and very worrisome,” stated David Weiss, an infectious diseases researcher at Emory University, in an email. Many individuals may be unrecognized carriers of these drug-resistant bacteria, which could facilitate community spread. Dr. Maroya Walters, one of the authors of the report, warned that infections once deemed routine, such as urinary tract infections, could evolve into chronic health issues due to this resistance.
Antimicrobial resistance occurs when bacteria and fungi develop the ability to resist the drugs designed to eliminate them. The misuse of antibiotics significantly contributes to this phenomenon, with factors such as unfinished or unnecessary prescriptions allowing bacteria to strengthen. The CDC has raised concerns over “nightmare bacteria” that resist a wide array of antibiotics, including carbapenems, which are typically reserved for severe infections.
The data used in the CDC report were collected from 29 states that conduct the necessary testing and reporting of carbapenem-resistant bacteria. The rate of such infections rose from just under 2 per 100,000 people in 2019 to more than 3 per 100,000 in 2023, marking a 69% increase. In contrast, infections linked to the NDM gene surged from approximately 0.25 to about 1.35 per 100,000 people, reflecting an astonishing 460% growth.
Challenges in Reporting and Treatment
The figures presented by the CDC likely underestimate the true scope of the problem. Many states do not conduct comprehensive testing and reporting of such cases. Even in states that do, cases commonly emerge among hospitalized patients who are already severely ill, necessitating special testing. Furthermore, numerous hospitals lack the capability to conduct tests for certain genetic resistance forms.
In light of the COVID-19 pandemic, the increase in drug-resistant infections is particularly concerning. Dr. Jason Burnham, a researcher at Washington University, highlighted that there was a substantial surge in antibiotic use during the pandemic, which likely contributed to the rise in drug resistance. The CDC’s findings indicate a critical need for improved testing and treatment protocols, as well as a concerted effort to address the misuse of antibiotics to curb the growing threat of antimicrobial resistance in the United States.
As public health officials work to combat this emerging crisis, the findings underscore the importance of awareness and action in tackling the challenges posed by resistant bacterial strains. The situation calls for a multifaceted approach, involving improved medical practices, public education, and robust research to safeguard against the rising tide of drug-resistant infections.
