Drug-resistant infections in the US aren’t just creeping up; they’re climbing sharply. A new CDC analysis finds carbapenem-resistant infections rose about 69% from 2019 to 2023, with the fiercest growth coming from bacteria that carry the NDM gene — short for New Delhi metallo-β-lactamase — now up more than fivefold over the same period.
Why that matters is simple and scary. Carbapenems are the antibiotics doctors lean on when everything else fails. NDM produces an enzyme that disables those last-resort drugs, leaving only a couple of expensive, IV-only options that aren’t always readily available. When bugs like these take hold, ordinary problems — urinary tract infections, pneumonias, wound and bloodstream infections — stop behaving like routine illnesses and start behaving like chronic threats.
The numbers, even as undercounts, tell the story. In 2023, across 29 states that routinely test and report these organisms, health departments logged 4,341 carbapenem-resistant infections, 1,831 of them tied to NDM. The overall rate climbed from just under two per 100,000 people in 2019 to just over three in 2023. NDM’s rate jumped from roughly a quarter of a case to about 1.35 per 100,000. Several of the nation’s most populous states — California, Florida, New York and Texas — weren’t included, and many hospitals still lack the lab tools to spot these resistance genes quickly, so the true national burden is almost certainly higher.
Public-health veterans have a working theory for how we got here. Years of antibiotic overuse and misuse gave tough microbes more chances to evolve, and the early pandemic poured fuel on the fire as clinicians, desperate to help severely ill patients, reached for antibiotics even against a viral disease. Historically, US NDM cases were tied to care abroad; now, after years of repeated introductions, the strain is circulating domestically and showing up in people with no overseas link at all.
The CDC’s worry isn’t limited to hospital wards. Agency scientists say it’s likely a significant number of people are carrying these bacteria without knowing it, especially in their gut, which opens the door to community spread in places like long-term care, outpatient clinics, and households. That’s when a hospital infection-control problem morphs into a neighborhood problem. The clinical challenge gets harder, too, because these infections look ordinary at first — burning and urgency from a UTI, cough and shortness of breath from pneumonia, fever and low blood pressure in the bloodstream — until a lab flags the resistance and treatment options narrow.
Speed and basics matter now more than ever. Hospitals and clinics need rapid testing to identify carbapenemases like NDM, aggressive infection-control around catheters and lines, and antibiotic stewardship that stops the “just in case” prescribing that strengthens the very microbes we’re trying to kill. Patients can do their part by asking whether an antibiotic is necessary, taking it exactly as prescribed when it is, and sticking to the unglamorous habits — handwashing, careful wound care, routine vaccinations — that prevent the bacterial complications where superbugs thrive.
None of this is cause for panic, but it is a clear call for urgency. A 69% jump in carbapenem-resistant infections and a fivefold rise in NDM isn’t a statistical quirk; it’s a signal that our best drugs are losing ground. The playbook that works — better surveillance, faster diagnostics, tighter infection control, and smarter antibiotic use — isn’t new. What’s new is how quickly we need to run it.
With input from NBC News, Al Jazeera, and the Washington Post.
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