United States: Infections from the so-called “nightmare bacteria” — strains armed with powerful drug-resistant traits — have escalated sharply in the United States. Between 2019 and 2023, their frequency soared by nearly 70%, a new Centers for Disease Control and Prevention (CDC) analysis shows.
The primary culprit: microbes carrying the NDM gene, notorious for making bacteria nearly invincible to most available medicines. According to CDC researchers writing in the Annals of Internal Medicine, only two antibiotic classes remain effective, both costly and delivered through intravenous lines, limiting accessibility.
Once considered an exotic threat linked mainly to patients treated abroad, NDM strains are no longer rare. Though absolute case counts remain modest, US infections multiplied more than fivefold in a short span, a trend infectious disease specialists call deeply unsettling.
“The rapid climb of NDM bacteria inside US borders is profoundly disturbing,” cautioned David Weiss of Emory University. “This danger is far from hypothetical,” according to the reports by AP news.
Scientists warn that many Americans may unknowingly harbor these resistant organisms, creating potential for community-level spread. That means conditions once viewed as minor inconveniences, such as urinary tract infections, could transform into lingering, hard-to-cure illnesses.
Government scientists say infection rates from drug-resistant “nightmare bacteria” have been increasing dramatically in the United States. https://t.co/Ptog2OAgtR pic.twitter.com/IMBtZHHJrT
— WAFB (@WAFB) September 24, 2025
Dr. Maroya Walters, co-author of the report, emphasized that unchecked antimicrobial resistance threatens to turn ordinary doctor visits into battlegrounds.
This resistance emerges when bacteria or fungi adapt to withstand drugs built to destroy them. A major driver has been the careless use of antibiotics — incomplete courses, excessive prescriptions, and misapplication — all of which give pathogens time to adapt and grow stronger.
The CDC has repeatedly flagged these pathogens as “nightmare bacteria.” Particularly concerning are carbapenem-resistant strains, since carbapenems are often the final line of defense for severe infections.
Data collected from 29 states that test and report such cases revealed 4,341 carbapenem-resistant infections in 2023, including 1,831 involving the NDM gene. Mortality figures were not disclosed.
From 2019 to 2023, carbapenem-resistant cases overall climbed from just under two per 100,000 residents to more than three — a 69% escalation. NDM-specific infections, however, spiked dramatically, from about 0.25 per 100,000 to 1.35, marking a staggering 460% increase, as reported by AP News.
Independent experts suggest the COVID-19 pandemic may have fueled the surge. “During the pandemic, antibiotic use exploded, and that undoubtedly amplified resistance,” said Jason Burnham of Washington University.
NEW: A report from @CDC_AR @CDCgov revealed that cases of an antibiotic-resistant nightmare bacteria are rising in the US. Incidence of carbapenemase-producing carbapenem-resistant Enterobacterales increased by 69% between 2019 and 2023. Read the full report here:… pic.twitter.com/j0Q3WNMnDC
— Annals of Int Med (@AnnalsofIM) September 24, 2025
Yet, the true scope may be far worse than the numbers reveal. Many states do not conduct full testing, and even in those that do, screening often focuses only on very ill hospitalized patients. Numerous hospitals also lack the capacity to detect advanced genetic resistance.
Crucially, data from major states — California, Florida, New York, and Texas — were missing, meaning the national tally is likely a significant undercount.
The CDC had already raised red flags earlier this year. A June bulletin pointed to a pronounced increase in NDM infections in New York City between 2019 and 2024.
The mounting evidence paints a grim portrait: drug-resistant bacteria are no longer an imported rarity but a domestic menace with the potential to reshape everyday medical care.