The United States is witnessing an alarming surge in human infections stemming from drug-resistant bacteria, warns the Centers for Disease Control and Prevention (CDC). The CDC lab tests have uncovered a dramatic increase in instances of a bacterium known as NDM-producing carbapenem-resistant Enterobacterales (NDM-CRE). This bacterium is a subset of the broader category of bacteria called carbapenem-resistant Enterobacterales (CRE), which are notorious for their resistance to many potent antibiotics. This resistance factor poses both a serious health concern and a major challenge in infection control.
The term ‘NDM’ denotes New Delhi metalo-beta-lactamase; an enzyme notorious for its remarkable resistance to almost all antibiotics. In the year 2020 alone, NDM-CRE reportedly caused an estimated 12,700 infections and 1,100 fatalities in the United States, according to the aforementioned source. Experts now fear these numbers could potentially escalate due to the current surge. The diverse categories of NDM-CRE infections include pneumonia, urinary tract infections, bloodstream infections, and wound infections. Complications arise due to these infections’ resistance to most antibiotics, leading to difficult treatment scenarios and often resulting in fatal outcomes. NDM-CRE’s contribution to healthcare challenges extends to its rapid contagious properties and common misdiagnosis or ignorance, due to its previously uncommon occurrence in the U.S.
According to Danielle Rankin, an epidemiologist in CDC’s Division of Healthcare Quality Promotion, the surge in NDM-CRE threats has complicated the already complex process of selecting proper treatment strategies within healthcare settings. It is vital, she says, for healthcare providers to have access to the necessary testing to aid in the application of targeted therapies. Dr. Marc Siegel, calling attention to the trend of antibiotic resistance, remarked it as a concerning trend contributing to a heightened risk of severe illness or death. Siegel attributes this trend partly to the overuse of antibiotics and a global trend which fosters increasing resistance.
Treatment options for carbapenem-resistant infections currently involve novel antibiotics such as ceftazidime-avibactam, meropenem-vaborbactam, plazomicin, and eravacycline. However, the production of these necessary antibiotics is hindered by the fact that it’s not profitable enough to manufacture them.
David Perlin, an infectious disease expert and a top brass at The Hackensack Meridian Center for Discovery and Innovation, points out that surveillance is not keeping pace with the evolution of the pathogens, and hence, keeping a check on drug resistances could be significantly improved. He went on to emphasize the necessity for healthcare providers to enhance their testing capabilities, especially in emergency departments, to rapidly identify these infections for effective treatment and infection control. He also identified that these dangerous strains can easily spread in various settings including hospitals, nursing homes, and the community at large. It thus remains crucial to persistently interact with doctors about persistent infections, and ensure early diagnosis, especially among immunocompromised patients within whom the pathogen can spread rapidly.