In the United States, a disturbing trend of antibiotic-resistant bacterial infections is gaining pace, necessitating an urgent call to action among infection prevention professionals. The Centers for Disease Control and Prevention (CDC) has warned of the increased occurrences of an antibiotic-resistant bacteria, known as NDM-producing carbapenem-resistant Enterobacterales (NDM-CRE). This bacteria belongs to a broader class of bacteria termed carbapenem-resistant Enterobacterales (CRE), which are known to resist some of the most potent antibiotics available.
This classification ‘NDM’ correspondingly represents an enzyme New Delhi metallo-beta-lactamase, known for its resistance to nearly all antibiotics. During 2020, infections from NDM-CRE were the primary cause of almost 12,700 infections and contributed to around 1,100 deaths in the U.S. A significant jump in NDM-CRE infections, including urinary tract infections, pneumonia, bloodstream infections, and wound infections, of over 460% between 2019 and 2023 has heightened the alarm.
Due to their resistance to most antibiotics, such infections present significant challenges for treatment and in many instances, can lead to fatal outcomes. They can spread rapidly across different communities and often remain misdiagnosed or overlooked due to their unfamiliarity.
In accordance with this rising threat, a growing complexity shadows treatment selection. Healthcare providers now require more access to testing capabilities to identify proper targeted therapies and initiate effective treatment promptly.
Novel antibiotics such as ceftazidime-avibactam, meropenem-vaborbactam, plazomicin, and eravacycline, are usually line of treatment for carbapenem-resistant infections. However, the limited profitability in producing these advanced antibiotics has resulted in their inadequate availability.
The predominant consensus among experts is the urgent need for enhanced surveillance to keep pace with pathogens’ evolution, rapid identification of such infections, particularly in emergency departments, improved doctor-patient interactions for identifying lingering infections, as well as effective infection control. In conjunction with these measures, maintaining sanitization across different settings and fostering early diagnosis comprise vital strategies, more so for immunocompromised patients in whom the bacteria can spread briskly.