CDC reports 460% surge in drug-resistant NDM-CRE infections

Editor's Note

NDM-producing carbapenem-resistant Enterobacterales are climbing fast and straining treatment choices, according to a September 23 release from the Centers for Disease Control and Prevention (CDC) and published in the Annals of Internal Medicine. The agency warns NDM-CRE infections rose more than 460% in the US from 2019 to 2023, and that this trend could drive overall CRE infections and deaths higher.

The release notes the CDC 2022 special report estimated roughly 12,700 CRE infections and 1,100 related deaths in 2020. The newer data highlight accelerating NDM-CRE, which includes pathogens that cause pneumonia, bloodstream infections, urinary tract infections, and wound infections. Many clinical laboratories cannot readily detect NDM-CRE, complicating timely and appropriate therapy.

NDM refers to New Delhi metallo beta-lactamase, an enzyme that renders bacteria resistant to nearly all available antibiotics, leaving few options. Danielle Rankin, an epidemiologist in CDC’s Division of Healthcare Quality Promotion, states the sharp rise limits the ability to treat serious infections and makes correct drug selection more challenging, which elevates the importance of access to testing for targeted therapy.

Why it matters for perioperative care, the outlet reported: NDM-CRE infections are difficult to treat, are associated with high morbidity and mortality, and can spread quickly in healthcare settings without strong infection prevention and control. CDC cites likely contributors that are still under study, including gaps in infection control, limited rapid testing capacity, and delayed organism identification that can increase transmission and slow treatment, and urges healthcare providers to stay informed about local and national CRE epidemiology, test promptly to identify the carbapenemase mechanism when CRE is detected, select treatment based on the resistance mechanism, and strengthen prevention.