CDC says drug-resistant infections and deaths have climbed since its last full report

The Centers for Disease Control and Prevention has released its first full update in years to the federal government's master accounting of drug-resistant infections, and the new numbers are larger than the last comprehensive tally. The agency's updated Antimicrobial Resistance Threats Report estimates that bacteria and fungi that no longer respond reliably to standard drugs now cause 9.7 million infections and 50,800 deaths in the United States every year.

The update, which CDC published this week, is the agency's first complete revision of the report since 2019. An interim release in 2024 had updated figures for only seven hospital-related pathogens. This version expands the roster to 19 organisms sorted into three tiers of severity, plus a separate watch list of six additional pathogens CDC is monitoring but has not yet fully quantified. News of the update was reported Tuesday by Fox-affiliated stations, including Fox 32 Chicago, and flagged to nursing home operators by the industry group AHCA/NCAL.

A larger count than the last full report

CDC's 2019 report, which covered 18 pathogens, put the annual toll at more than 2.8 million antimicrobial-resistant infections and more than 35,000 deaths, according to the agency's own 2019 fact sheet. The new estimate of 9.7 million infections and 50,800 deaths is not a precise apples-to-apples comparison, since the agency added a pathogen, revised its surveillance methods and drew on newer hospital, laboratory and state health department data. But the direction is unambiguous: more infections, more deaths, and more organisms being tracked.

The full list of threats is organized into four tiers. Four pathogens are classified "urgent," meaning CDC says they require urgent and aggressive action: the fungus Candida auris, carbapenem-resistant Acinetobacter, carbapenem-resistant Enterobacterales (known as CRE), and drug-resistant gonorrhea. Thirteen more, including C. diff, MRSA and multidrug-resistant Pseudomonas aeruginosa, are labeled "serious." Two are "concerning," and six more organisms, including drug-resistant whooping cough and a drug-resistant sexually transmitted pathogen, sit on the newly expanded watch list.

A fungus spreading faster than almost anything else on the list

Among the four urgent threats, Candida auris stands out for how quickly it has grown. The fungus, first identified in a US patient in 2016, caused 4,523 clinical cases in 2023, according to figures CDC gave reporters and that were detailed in the Fox 32 Chicago report. That is a jump of more than 50% from 2022 and nearly a tenfold increase since 2019. Screening tests that detect colonization without active infection found another 9,270 cases that year. As of this spring, more than 20 states were sharing detailed Candida auris case data with CDC through a surveillance system called FungiSurv, up from a much smaller handful of states when the fungus was first flagged as an urgent threat.

Candida auris spreads mainly in hospitals and nursing homes, often among patients who are already seriously ill, have invasive medical devices such as catheters or ventilators, or have spent extended time in intensive care. It resists most antifungal drugs and survives for extended periods on hospital surfaces and equipment, which has made outbreaks difficult to contain once it enters a facility.

Where the burden falls hardest

The report's case counts show the toll concentrated among hospitalized and older patients. CDC estimated 412,504 cases of C. diff, a gut bacterium that causes severe diarrhea, among hospitalized patients in 2023, with 11,339 deaths and more than $6.4 billion in costs. Adults 65 and older had C. diff infection rates four-and-a-half to five times higher than younger people. CRE, a family of bacteria resistant to a last-resort class of antibiotics, caused 14,878 cases and 1,252 deaths among hospitalized patients, with an estimated $174 million in associated costs.

Drug-resistant gonorrhea, the fourth urgent threat, caused an estimated 787,000 infections nationally, with projected lifetime medical costs of roughly $214.5 million. The trend is not confined to hospitals: Minnesota's health department, cited in the Fox coverage, reported that cases of disseminated gonococcal infection, a severe bloodstream complication of the disease, rose fourfold in that state in 2024 alone.

Taken together, the pathogens on CDC's list disproportionately affect people who are hospitalized, elderly, immunocompromised, or undergoing procedures such as surgery, dialysis or chemotherapy that rely on antibiotics working as expected. Public health officials have long warned that routine medical care, from joint replacements to cancer treatment, depends on antibiotics continuing to be effective against common infections.

• Urgent threats: Candida auris, carbapenem-resistant Acinetobacter, carbapenem-resistant Enterobacterales (CRE), drug-resistant gonorrhea
• Serious threats: 13 pathogens including C. diff, MRSA, drug-resistant tuberculosis and multidrug-resistant Pseudomonas aeruginosa
• Concerning threats: drug-resistant group A and group B streptococcus
• Watch list: six additional organisms, including drug-resistant Aspergillus fumigatus and Bordetella pertussis, being monitored for a fuller burden estimate

A shift to continuous tracking, and what comes next

Beyond the new numbers, CDC changed how it will publish this data going forward. Rather than releasing a single static report every several years, the agency has moved the threats report onto a continuously updated web portal and says it will issue new burden estimates at least every two years. That is a response, in part, to the roughly six-year gap between the 2019 report and this full update, which left policymakers, hospitals and nursing homes working from older figures for much of that stretch.

AHCA/NCAL, which represents long-term care facilities, is telling members to have infection-control staff compare the new figures against their own facilities' trends and against state or local health guidance. The group stressed that the update itself does not create any new federal regulatory requirement.

For hospitals and nursing homes, the near-term response is likely to center on infection prevention basics: hand hygiene, screening of high-risk patients, isolation protocols for colonized or infected patients, and continued expansion of state reporting networks such as FungiSurv. CDC has also continued to push antibiotic stewardship programs aimed at reducing unnecessary prescribing, which drives the selective pressure that produces resistant strains in the first place. With the agency now committed to updating its estimates every two years instead of nearly every decade, the next test of whether the growth in cases and deaths continues, or whether lower infection rates reported for a couple of resistant organisms in recent years spread more broadly, should come well before the end of the decade.