When I had Valley Fever, I spent months facing misdiagnoses. At one point, I received intravenous antibiotics at an urgent care clinic. Because Valley Fever is a fungal infection, those antibiotics could not help. Misapplied treatments like this add to a larger crisis: antibiotic resistance.
The Centers for Disease Control and Prevention (CDC) recently issued an alarming report on NDM-producing, carbapenem-resistant Enterobacterioles (NDM-CREs). These are dangerous strains of bacteria that resist nearly all antibiotics. The study, published in Annals of Internal Medicine, shows infections rose more than 460% between 2019 and 2023.
NDM-CRE infections can include pneumonia, bloodstream infections, urinary tract infections, and wound infections. They are extremely hard to treat and can be fatal. Detection is also difficult, since many clinical labs lack the tools to identify them.
What Are NDM-CRE Infections?
New Delhi metallo-β-lactamase (NDM) is the enzyme behind NDM-CRE. This enzyme makes bacteria resistant to nearly all approved antibiotics. As a result, NDM-CRE infections have very limited treatment options.
These strains were once rare in the United States. Because of this, health professionals may not identify them quickly enough. That delay can result in inadequate or misapplied treatments.
NDM-CRE infections carry high rates of fatality and serious complications. The bacteria also spread rapidly, threatening hospitals, clinics, schools, and other vulnerable settings.
Why Are NDM-CRE Infections Spreading?
There are several reasons why NDM-CRE bacteria are spreading so quickly. Poor hand hygiene, insufficient PPE, and inadequate disinfection are major factors. Another is the lack of proper detection tools. Without them, NDM-CRE strains may go unnoticed or be misdiagnosed.
Because of this, the CDC strongly urges health providers to stay alert. Providers should track the spread of NDM-CRE in their local areas. They should also be able to identify the specific carbapenem resistance present in an infection. This knowledge can guide which antibiotics, if any, might still be effective.
Who is Most at Risk from NDM-CRE Infections?
The people at highest risk for NDM-CRE infections are in healthcare settings. Transmission is especially likely in patients with suppressed immune systems. Equipment such as ventilators, urinary catheters, or IV lines can increase the risk of spread. Patients receiving long courses of antibiotics are also more vulnerable.
NDM-CRE spreads through physical contact. This can include unwashed hands, infected wounds, or stool. The CDC advises that people prescribed antibiotics follow their provider’s instructions carefully. Patients should also complete the full course, even if symptoms improve.
Transmission of NDM-CRE from animals is considered unlikely. Still, consulting a veterinarian about a pet’s medical history may be worthwhile.
Conclusion
NDM-CRE infections are rising rapidly and pose serious health threats. Limited treatments and difficult detection make prevention especially important. Strong hygiene, careful antibiotic use, and provider awareness are critical to slowing their spread.
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Logan Hamilton is a health and wellness freelance writer for hire. He’s passionate about crafting crystal-clear, captivating, and credible content that elevates brands and establishes trust. When not writing, Logan can be found hiking, sticking his nose in bizarre books, or playing drums in a local rock band. Find him at loganjameshamilton.com.

