CDC Report Finds Sharp Rise in Dangerous Drug-Resistant Bacteria Changes in Carbapenemase-Producing Carbapenem-Resistant Enterobacterales, 2019 to 2023

A new CDC report in Annals of Internal Medicine warns of a sharp rise in NDM-producing carbapenem-resistant Enterobacterales (NDM-CRE)—a highly drug-resistant group of bacteria.

• Infections & deaths: CRE caused ~12,700 infections and 1,100 deaths in the U.S. in 2020.

• Surge: Between 2019–2023, NDM-CRE infections rose by >460%. They cause pneumonia, bloodstream, urinary tract, and wound infections that are often deadly and very hard to treat.

• Treatment challenge: NDM (New Delhi metallo-β-lactamase) makes bacteria resistant to nearly all available antibiotics, leaving few options. Many labs lack the capacity to detect NDM-CRE, delaying correct treatment.

• Risks:

  • High morbidity and mortality.

  • Can spread rapidly in healthcare settings and communities.

  • Difficult to recognize in time, as it has been historically rare in the U.S.

Possible drivers: Gaps in infection control, inconsistent hygiene practices, and limited lab testing capacity.

CDC recommendations:

• Stay informed about local CRE epidemiology.

• Test promptly for carbapenemase type to guide treatment.

• Select treatment carefully, based on resistance mechanisms.

• Strengthen prevention through rigorous infection control, protective equipment, and collaboration with state/local HAI/AR programs.

Bottom line: The steep increase in NDM-CRE poses a major public health threat by limiting treatment options and heightening risks of severe outcomes and spread.