What are ‘nightmare bacteria’ and why are infections rising in the US?

According to a report from the nation’s national public health agency, the Centers for Disease Control and Prevention (CDC), the country’s national public health agency, the number of infections caused by drug-resistant, “nightmare bacteria” increased by almost 70% between 2019 and 2023.

According to researchers, drug-resistant bacteria with the so-called “NDM gene” (New Delhi metallo-lactamase) are what are causing the rise. Once thought to be “exotic,” bacteria carrying the NDM gene were only linked to a select few patients, most of whom were outside the US.

Some “nightmare bacteria” have only recently been identified as being effective against one particular type of antibiotic, known as carbapenems. However, these may now be completely ineffective due to the presence of NDM-gene bacteria.

What findings did the report on drug-resistant bacteria reveal?

The researchers reported on Monday that while the absolute numbers of people in the US are still low, cases have increased alarmingly in recent years.

According to The Associated Press, David Weiss, a researcher at Emory University in infectious diseases, “the rise of NDMs in the US is a grave danger and very worrisome.”

Data from 29 states that tested for and reported cases of carbapenem-resistant bacteria was available to researchers. In those states, according to them, there were 4, 341 cases of carbapenem-resistant bacterial infections in 2023, of which 831 were of the NDM-gene variety.

How do bacteria develop drug resistance?

When bacteria discover new ways to fight off the drugs that are intended to kill them, they can develop “antimicrobial resistance.”

The misuse of antibiotics has increased as a result of people not taking the necessary antibiotics, which prevent bacteria from getting “used” to an antibiotic and developing a resistance to it. Then, resistant bacteria can survive and transmute their genes to other strains.

In the US, there are more than 3 per 100 000 people who are resistant to carbapenem in 2023, an increase of 69 percent over the same time last year. However, according to the authors, the prevalence of NDM cases increased by 460 percent to about 1.35 per 100, 000 people.

Therefore, the CDC scientists said it’s possible that some people are unrecognised carriers of the NDM-gene bacteria, which could cause community spread. If untreated, common infections like urinary tract infections can also become more dangerous.

Why are drug-resistant infections becoming more prevalent?

According to experts, the COVID-19 pandemic may be a factor in the rise in US cases.

According to Dr. Jason Burnham, a researcher at Washington University, “we know that there was a huge spike in antibiotic use during the pandemic, so this likely is reflected in growing drug resistance.”

Additionally, the most recent CDC count is likely only to provide a rough picture. Many states do not perform a carbapenem-resistant bacterial infection test. Testing is typically only performed on hospital patients who are extremely ill even in those states where it is legal.

The CDC researchers also had access to data from some of the country’s most densely populated regions, including California, Florida, New York, and Texas, which suggests that the overall incidence of US infections is “definitely underestimated,” according to Burnham.

What are the first warning signs of a carbapenem-resistant infection?

Carbapenem-Resistant Enterobacteriaceae (CRE) infections are difficult to identify because they don’t differ significantly from common bacterial illnesses. Typical warning signs include:

• Urinary tract infections cause burning sensations, frequent urinate urges, or “cloudy” urine.
• High fever, heartbeat, rapid heartbeat, or very low blood pressure are symptoms of bloodstream infections.
• Cough, breathlessness, or chest pain are symptoms of pneumonia (lung infection).

Are “crawler bacteria” becoming more prevalent in other nations as well?

Although the prevalence of bacteria that contain the NDM gene varies by region, they are also a problem elsewhere in the world.

South Asia: India and Pakistan, for example, are the only countries where NDM-producing bacteria are more prevalent than in other parts of the world. The overuse of antibiotics, the lack of regulation for generic ones, and overcrowded hospitals all contribute to this by making infection spread more likely.
• Europe: According to investigations, southern European nations like Greece, Italy, and Turkiye report more “nightmare bacteria” cases than those in northern Europe, where strong antibiotic stewardship programs and infection control measures are more prevalent.
• Africa: Although there are only limited details, studies have found that resistant bacteria can be found in both community and hospital settings. The lack of diagnostic capacity frequently leads to underreporting, while unregulated antibiotic use and poor sanitation infrastructure also contribute to the spread of infections.
• Latin America: Brazil and Argentina, where outbreaks have been reported in 2021 and 2022, are a growing concern.

Source: Aljazeera