Reviewed by Shipra Gupta, MD, MS, Children’s Hospital at Montefiore
Bottom-line- U.S. surveillance reveals a striking increase in New Delhi Metallo-beta-lactamase producing-carbapenem-resistant Enterobacterales (NDM-CRE) from 2018–2023, driven largely by community-associated infections.
The study by Duffy et al. demonstrates a nearly 10-fold increase in NDM-CRE incidence in the U.S. from 2018–2023, with a notable shift toward community-associated infections.
These findings are reinforced by a 2025 CDC MMWR report from New York City, where NDM-CRE cases increased from 58 in 2019 to 388 in 2024 and surpassed KPC-CRE as the most frequently detected carbapenemase.
Together, these data suggest that NDM-CRE is no longer confined primarily to traditional healthcare-associated settings, highlighting the importance of travel history, surveillance, rapid carbapenemase testing, and infection prevention. The changing epidemiology also has therapeutic implications, as NDM-CRE may require treatment approaches different from those used for KPC-CRE.
References:
Duffy N, et al. Rising Incidence of New Delhi Metallo-β-Lactamase-Producing Carbapenem-Resistant Enterobacterales, 10 US Sites, 2018-2023. OFIC. 2026 Aug 8;13(8):ofag477. DOI: https://doi.org/10.1093/ofid/ofag477
Devinney K, et al. Notes from the Field: Increase in New Delhi Metallo-β-Lactamase–Producing Carbapenem-Resistant Enterobacterales — New York City, 2019–2024. MMWR 2025;74:401–403. DOI: http://dx.doi.org/10.15585/mmwr.mm7423a2
