Rising Incidence of New Delhi Metallo-β-Lactamase–Producing Carbapenem-Resistant Enterobacterales, 10 US Sites, 2018–2023
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background We described the changing epidemiology of New Delhi metallo-β-lactamase (NDM)–producing carbapenem-resistant Enterobacterales (CRE) in 10 US sites conducting population-based CRE surveillance during 2018–2023. Methods A CRE case was defined as the first isolation of Escherichia coli, Enterobacter spp., or Klebsiella spp. resistant to ≥1 carbapenem from a sterile site or urine in a surveillance area resident within a 30-day period. Cases were classified as healthcare-associated or community-associated. Incidence rates were calculated using census data; trends were assessed using the Mann–Kendall test. Multivariable logistic regression was used to compare NDM- and Klebsiella pneumoniae carbapenemase-producing (KPC)–CRE. A subset of isolates underwent whole-genome sequencing. Results During 2018–2023, CRE incidence increased from 5.34 to 7.65 per 100 000 population (P = .02). NDM-CRE incidence increased from 0.07 to 0.66 per 100 000 population (P = .02); no significant trend was observed for KPC-CRE. Odds of being an NDM-CRE case were increased for community-associated versus healthcare-associated cases (adjusted odds ratio [aOR], 3.2; 95% CI, 1.98–5.17) and for cases aged 0–24 years versus ≥75 years (aOR, 3.99; 95% CI, 1.59–10.02). Genomic analysis showed diversity of sequence types among NDM- versus KPC-CRE. Conclusions Increases in CRE incidence appear to be driven by NDM-CRE, which are more likely than KPC-CRE to be community-associated. Continued surveillance is recommended to understand changes in epidemiology.
Source: Open Forum Infectious Diseases
DOI: 10.1093/ofid/ofag477
Authors: Nadezhda Duffy, Davina Campbell, Rongxia Li, Joshua Brandenburg, Uzma Ansari, Alyssa G Kent, Joelle Nadle, Karlie Hoetzer, Helen Johnston, Jennifer Driscoll, Christopher Czaja, Meghan Maloney, Jesse T Jacob, Gillian Smith, Elisabeth Vaeth, Lucy E Wilson, Laura Tourdot, Annastasia Gross, Sean O Malley, Ruth Lynfield, Ghinwa Dumyati, Hsioa Che Looi, Julia Tellerman, Marisa R Hoffman, Kristina G Flores, Heather Hertzel, Daniel Muleta, Christopher D Wilson, Maria Karlsson, Amy S Gargis, Alice Y Guh
Institutions: Centers for Disease Control and Prevention, Colorado Department of Public Health and Environment, Connecticut Department of Public Health, Emory University, Atlanta VA Medical Center, Maryland Department of Health, Minnesota Department of Health, University of Rochester Medicine, New Mexico Department of Health, Oregon Health Authority, Tennessee Department of Health
Language: English
Subfield: Molecular Medicine
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $4,053
OpenAlex ID: W7201971275