For over a decade, healthcare facilities in the United States have been grappling with the specter of carbapenem-resistant Enterobacterales (CRE). This group of bacteria has returned with a vengeance, thanks to the rise of the New Delhi metallo-β-lactamase-producing CRE (NDM-CRE), a formidable foe resistant to multiple therapeutic options.
The Centers for Disease Control and Prevention (CDC) has flagged a marked uptick in reports of carbapenemase-producing CRE, a development highlighted in a recent study published in the Annals of Internal Medicine. The study, called ‘Changes in Carbapenemase-Producing Carbapenem-Resistant Enterobacterales, 2019 to 2023’, documents a five-fold uptick in NDM-CRE across 29 states. Shockingly, data for early 2024 indicates this potent pathogen has maintained its elevated presence.
The healthcare implications of this surge are profound, as NDM-CRE is known to resist many last-resort therapeutics, including β-lactams. The escalating prevalence of NDM-CRE places fundamental hospital procedures, from organ transplants to chemotherapy, at risk, as these processes rely heavily on potent antibiotics. These drug-resistant pathogens pose a substantial threat, eroding our healthcare system’s resilience and potentially exacerbating the impact of other health emergencies like influenza or pandemics.
To address the fast international spread of these pathogens, facilitated by patient transfers and global travel, coordinated surveillance and infection-prevention strategies are necessary on a worldwide scale. The CDC and AR Lab Network, encompassing regional labs and public health partners across the nation, have been fundamental in both identifying this trend and offering necessary tests in regions lacking resources. Identifying these resistant strains promptly allows for swift action in infection control within hospitals and aids clinicians in picking the most effective treatments. The AR Lab Network’s efforts thus feed directly into the nation’s strategy to counter antimicrobial resistance.
However, to truly tackle the dominance of NDM-CRE, continued federal and state investments in both antimicrobial resistance surveillance and clinical capacity is crucial. This challenge necessitates collaboration between healthcare facilities, public health departments, industry, and policymakers, transcending hospital walls to underline the inherent fragility of our antibiotic pipeline and the pressing need for new treatment options and diagnostics.
Despite warnings that containment will be challenging without consistent adherence to infection-control protocols, expanded laboratory testing and careful stewardship of limited antibiotics, the CDC remains hopeful. Sustained awareness among clinicians and ongoing investment in public health infrastructure is vital to avoid the loss of progress made in combating drug-resistant infections.
Source: https://globalbiodefense.com/2025/09/26/cdc-ndm-cre-surge-drug-resistant-bacteria-2025/