What to know about spiking "nightmare bacteria" and CDC's new warning

• Recently, the CDC has pointed to "nightmare bacteria" resistant to antibiotics as a major potential danger. These are largely hospital-acquired infections.
• Specifically, there's been concern about a group of bacteria called Enterobacterales that resist antibiotic treatments — specifically carbapenems, a type of antibiotic often used in worst-case scenarios for serious infections.
• The carbapenem-resistant Enterobacterales (CRE) were labeled "nightmare bacteria" by former CDC director Tom Frieden in 2013.

Rise in "nightmare bacteria" cases

Driving the news: CDC researchers wrote Tuesday in the Annals of Internal Medicine that infections from bacteria resistant to powerful antibiotics are spiking.

• The resistance is mainly driven by the "NDM" gene, which creates an enzyme that destroys antibiotics.
• The study analyzed cases reported by 29 states, but not California, Florida, New York or Texas.

By the numbers: The rate of carbapenem-resistant infections jumped from under 2 per 100,000 in 2019 to more than 3 per 100,000 in 2023, an approximate 69% jump, the researchers said.

• The rate of CRE infections with the NDM gene jumped by 461%, the study said.
• In 2019, 24 states saw a total of 2,267 cases. In 2023, 29 states saw 4,341 cases total, the report said.

Threat of "nightmare bacteria"

Threat level: "They pose a triple threat," Frieden said — high mortality rates, resistance to drugs and easy spread to other bacteria.

• It's likely people wouldn't recognize they're carrying the bacteria, igniting community spread, the CDC scientists said, per AP.

• In 2020, "CRE" infections caused about 12,700 infections and 1,100 deaths, per Scientific American.
• A September study in eClinical Medicine found about one-third of hospital infections were antimicrobial-resistant.

"Nightmare bacteria" symptoms

The CDC lists the symptoms and signs of CRE infection, including:

• Pneumonia,
• Bloodstream infections,
• UTIs,
• Wound infections and
• Meningitis.

Patients most at risk are those in health care settings, especially those using ventilators, urinary catheters or vein catheters, the CDC says.

• Others at risk include patients on long-term courses of antibiotics and with weakened immune systems, per the CDC.

How "nightmare bacteria" spreads

CRE bacteria spread through contact with dirty hands, wounds or feces — and from medical equipment, per the CDC.

• There have been rare reports of spread between animals and humans.
• Some people can carry the bacteria without symptoms or illness.

Go deeper: More Americans die from superbugs than previously estimated, CDC says