CDC Warns of Superbugs Responsible for Tens of Thousands of U.S. Deaths Each Year

— Agency flags 19 pathogens, including four drug-resistant bugs, on its "urgent threats" list

Key Takeaways

• An updated CDC report includes 19 pathogens whose threat levels range from "concerning" or "serious" to the top-tier "urgent" category.
• Clostridioides difficile moved from an urgent threat to a serious threat, in part because of improved infection prevention efforts.
• Six pathogens were added to the agency's watch list of possible threats, including drug-resistant dermatophytes and drug-resistant Haemophilus influenzae.

Candida auris, Acinetobacter, Enterobacterales, and Neisseria gonorrhoeae sit at the top of the CDC's revised list of drug-resistant pathogens that endanger public health and require aggressive action.

The CDC's updated Antimicrobial Resistance Threats Report outlines the country's most concerning infectious agents, identifying 19 pathogens whose risk levels range from "concerning" and "serious" to the highest "urgent" tier, along with six others placed on the agency's watch list for potential threats.

Altogether, the pathogens are estimated to cause 9.7 million infections each year and 50,800 deaths, according to the agency.

"These numbers are alarming by any measure, but they are particularly sobering when infectious diseases physicians connect real patients with these statistics in their everyday experience," Wendy Armstrong, MD, president of the Infectious Diseases Society of America, said in a statement.

"Drug-resistant infections prolong hospital stays, drive up healthcare costs, and make it increasingly difficult -- and sometimes impossible -- for doctors to safely provide care like cancer chemotherapy, organ transplants, hip and knee replacements, and other medical care and surgeries," she added.

New additions to the report and pathogens that changed category include:

• Drug-resistant N. meningitidis, which emerged as a serious threat requiring prompt and sustained action
• Drug-resistant dermatophytes, which the CDC added to its watch list of emerging pathogens with an uncertain disease burden that could become a potential threat
• Drug-resistant Haemophilus influenzae, which also joined the CDC's pathogen watch list
• Nontuberculous mycobacteria, another addition to the CDC's watch list
• Clostridioides difficile, which dropped from an urgent threat to a serious threat, aided in part by infection prevention measures that have reduced case numbers since 2011

Armstrong urged passage of the PASTEUR Act, which would establish a federal program to support development of antimicrobial drugs against the most dangerous pathogens and infections. Both versions of the bill remain stalled in congressional committees.

America's Top Pathogen Public Enemies

Four drug-resistant pathogens were placed on the CDC's highest "urgent threats" list:

C. auris, also called Candidozyma auris, is an emerging multidrug-resistant yeast that can cause severe, life-threatening infections, especially in patients with serious underlying medical conditions. Reported U.S. cases have risen from 48 in 2016, when it was first identified, to 4,523 in 2023.

Carbapenem-resistant Acinetobacter can cause infections almost anywhere in the body and is a particular danger for patients in hospitals and nursing homes, where it can spread through contaminated surfaces and equipment. In 2023, it led to 9,497 U.S. hospitalizations, with most cases beginning outside the hospital (63%). The drug-resistant pathogen was responsible for an estimated 817 U.S. deaths that year.

Carbapenem-resistant Enterobacterales includes strains of Escherichia coli and Klebsiella. Patients on ventilators, those with catheters, and people receiving long courses of antibiotics face a higher risk of these infections, which have limited treatment options. Carbapenem-resistant Enterobacterales caused 14,878 hospitalizations in 2023 and an estimated 1,252 deaths.

Drug-resistant N. gonorrhoeae makes gonorrhea harder to treat, raising the risk of pelvic inflammatory disease, ectopic pregnancy, infertility, and both acquiring and transmitting HIV. The FDA approved gepotidacin (Blujepa) and zoliflodacin (Nuzolvence) as the first new antibiotics for gonorrhea in decades. In 2023, drug-resistant N. gonorrhoeae was responsible for an estimated 787,000 infections in the U.S. Overall, 55.4% of gonorrhea cases in 2023 were resistant to at least one of six antibiotics or showed elevated minimum inhibitory concentrations.