Introduction to Nightmare Bacteria
The United States is witnessing a significant rise in infection rates from drug-resistant "nightmare bacteria," with a nearly 70% increase between 2019 and 2023, according to a recent report from the Centers for Disease Control and Prevention (CDC) scientists. This alarming trend is primarily driven by bacteria carrying the New Delhi metallo-beta-lactamase (NDM) gene, which renders them highly resistant to most antibiotics.
What are Nightmare Bacteria?
Nightmare bacteria are strains of bacteria that have developed resistance to multiple antibiotics, making them extremely difficult to treat. The NDM gene is a key factor in this resistance, as it enables bacteria to produce an enzyme that breaks down the majority of antibiotics, including carbapenems, which are often considered the last line of defense against serious infections.
Rise of NDM Bacteria in the US
Historically, NDM bacteria were rare in the US and were mostly associated with patients who had received medical care overseas. However, the latest data indicates a more than fivefold increase in NDM cases in recent years, suggesting that these bacteria are becoming more widespread in the US. This rise is particularly concerning, as it indicates that the bacteria are likely being transmitted within the US, potentially leading to community spread.
Impact on Public Health
The increase in nightmare bacteria cases poses a significant threat to public health. As these bacteria become more common, infections that were once easily treatable, such as urinary tract infections, may become chronic problems. This could lead to a surge in hospitalizations and increased mortality rates. Furthermore, the misuse of antibiotics, including unfinished or unnecessary prescriptions, has contributed to the rise of antimicrobial resistance, making it essential to adopt more responsible antibiotic use practices.
Current Data and Limitations
According to the CDC report, there were 4,341 cases of carbapenem-resistant bacterial infections in 29 states that conducted the necessary testing and reporting in 2023. Of these, 1,831 cases were attributed to NDM bacteria. While the rate of carbapenem-resistant infections increased by 69% between 2019 and 2023, the rate of NDM cases rose by a staggering 460% during the same period. However, it is essential to note that the CDC’s count is only a partial picture, as many states are not fully testing and reporting cases, and even in states that do, cases tend to be among hospital patients who are sick enough to warrant special testing.
Possible Link to the COVID-19 Pandemic
Some researchers suggest that the increase in nightmare bacteria cases may be linked to the COVID-19 pandemic, which saw a significant surge in antibiotic use. This increased use of antibiotics could have accelerated the development of antimicrobial resistance, contributing to the rise in nightmare bacteria cases.
Conclusion
The rising incidence of nightmare bacteria cases in the US is a grave concern that requires immediate attention. The spread of NDM bacteria, in particular, poses a significant threat to public health, as these bacteria are highly resistant to most antibiotics. It is crucial to adopt more responsible antibiotic use practices, improve testing and reporting of cases, and develop new treatments to combat these deadly infections.
FAQs
- What are nightmare bacteria?
Nightmare bacteria are strains of bacteria that have developed resistance to multiple antibiotics, making them extremely difficult to treat. - What is the NDM gene?
The NDM gene is a key factor in antimicrobial resistance, as it enables bacteria to produce an enzyme that breaks down the majority of antibiotics. - How common are nightmare bacteria in the US?
While the numbers are still small, the rate of nightmare bacteria cases in the US has increased significantly in recent years, with a nearly 70% rise between 2019 and 2023. - What is the link between the COVID-19 pandemic and the rise of nightmare bacteria?
Some researchers suggest that the increased use of antibiotics during the COVID-19 pandemic may have contributed to the rise in antimicrobial resistance, leading to an increase in nightmare bacteria cases. - What can be done to combat the rise of nightmare bacteria?
To combat the rise of nightmare bacteria, it is essential to adopt more responsible antibiotic use practices, improve testing and reporting of cases, and develop new treatments to combat these deadly infections.
By MIKE STOBBE, AP Medical Writer
NEW YORK (AP) — Infection rates from drug-resistant “nightmare bacteria” rose almost 70% between 2019 and 2023, according to a new report from Centers for Disease Control and Prevention scientists.
Bacteria that are difficult to treat due to the so-called NDM gene primarily drove the increase, CDC researchers wrote in an article published Monday in the Annals of Internal Medicine. Only two antibiotics work against those infections, and the drugs are expensive and must be administered through an IV, researchers said.
Bacteria with the gene were once considered exotic, linked to a small number of patients who received medical care overseas. Though the numbers are still small, the rate of U.S. cases jumped more than fivefold in recent years, the researchers reported.
“The rise of NDMs in the U.S. is a grave danger and very worrisome,” said David Weiss, an Emory University infectious diseases researcher, in an email.
It’s likely many people are unrecognized carriers of the drug-resistant bacteria, which could lead to community spread, the CDC scientists said.
That may play out in doctors’ offices across the country, as infections long considered routine and easy to treat — like urinary tract infections — could become chronic problems, said Dr. Maroya Walters, one of the report’s authors.
Antimicrobial resistance occurs when germs such as bacteria and fungi gain the power to fight off the drugs designed to kill them. The misuse of antibiotics was a big reason for the rise — unfinished or unnecessary prescriptions that didn’t kill the germs made them stronger.
In recent years, the CDC has drawn attention to “ nightmare bacteria ” resistant to a wide range of antibiotics. That includes carbapenems, a class of antibiotics considered a last resort for treatment of serious infections.
Researchers drew data from 29 states that do the necessary testing and reporting of carbapenem-resistant bacteria.
They counted 4,341 cases of carbapenem-resistant bacterial infections from those states in 2023, with 1,831 of them the NDM variety. The researchers did not say how many of the infected people died.
The rate of carbapenem-resistant infections rose from just under 2 per 100,000 people in 2019 to more than 3 per 100,000 in 2023 — an increase of 69%. But the rate of NDM cases rose from around 0.25 to about 1.35 — an increase of 460%, the authors said.
A researcher not involved in the study said the increase is probably related to the COVID-19 pandemic.
“We know that there was a huge surge in antibiotic use during the pandemic, so this likely is reflected in increasing drug resistance,” said Dr. Jason Burnham, a Washington University researcher, in an email.
The CDC’s count is only a partial picture.
Many states are not fully testing and reporting cases. Even in states that do, cases tend to be among hospital patients sick enough to warrant special testing. Many hospitals also aren’t able to do the testing needed to detect certain forms of genetic resistance.
The CDC researchers did not have data from some of the most populous states, including California, Florida, New York and Texas, which means the absolute number of U.S. infections “is definitely underestimated,” Burnham said.
This is not the first study to report a rise. A CDC report published in June noted an increase in NDM cases in New York City between 2019 and 2024.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
<p>Originally Published: September 23, 2025 at 12:19 PM EDT</p>
