CDC Report Puts Drug-Resistant Infections at 9.7 Million a Year and Deaths at 50,800, While Warning Against Comparing It to 2019

Since the CDC's last threats report in 2019 estimated 2.8 million resistant infections and 35,000 deaths a year, the agency has published a new assessment. Released Tuesday, Oct. 27, it puts the figures at 9.7 million infections and 50,800 deaths annually. The numbers are based on 2023 data.

The report covers 19 pathogens. Four are rated "urgent," 13 "serious" and two "concerning." Six more sit on a watch list, ranging from ringworm-causing fungi to whooping cough bacteria.

Hospitals carry most of the death toll

Infections commonly acquired in health care settings accounted for more than 42,000 of the 50,800 deaths, the CDC said. The agency put the cost to the U.S. health system at more than $12 billion.

Dr. Emily Landon, an infectious disease specialist at UChicago Medicine, said the greatest danger falls on patients with complicated hospital infections and on people in congregate care such as nursing homes and long-term acute care facilities, where antibiotics are used heavily. Her prevention advice was basic: hygiene, masks and gloves, and consistent practice by staff.

CDC Director Dr. Erica Schwartz said in a press release that "antimicrobial resistance threatens modern medicine and puts millions of Americans at risk every year." She added that the data shows "both the progress we've made and the significant work that remains."

The four urgent threats

Candida auris. The fungus is almost completely resistant to one class of antifungal drugs and has shown emerging resistance to the other two. It caused 4,523 infections in 2023, a tenfold increase from 2019, according to the CDC. It was first detected in U.S. hospitals about a decade ago. It spreads on medical equipment such as breathing tubes and catheters, and people can carry it on their skin without being sick.

Tom Chiller, a former chief of the CDC's Mycotic Diseases Branch, said resistant C. auris infections are fatal in 29% to 62% of patients. Few antifungal drugs exist to treat them.

Drug-resistant gonorrhea. The CDC estimates about 787,000 such infections in 2023.

Carbapenem-resistant Enterobacterales. These gut bacteria, which include E. coli, caused an estimated 14,878 infections in hospitalized patients and 1,252 deaths in 2023.

Carbapenem-resistant Acinetobacter. Like the Enterobacterales, it resists some of the strongest antibiotics available. The result for patients is fewer treatment options, longer stays and a higher risk of life-threatening complications.

What moved on the list

Clostridioides difficile, the cause of life-threatening colon inflammation, was an urgent threat in 2019. It has been downgraded to serious.

Drug-resistant Neisseria meningitidis, which causes meningitis and bloodstream infections, is newly listed as a serious threat. It differs from most items on the list because it spreads in ordinary settings through close contact, such as shared drinks or college dorms.

Landon pointed to rising resistance to ceftriaxone, the main antibiotic used to treat it. "The only thing that would complicate that really terrifying infection more is if it's resistant to the antibiotics that we often use for it," she said.

The 2019 comparison

The jump from 2.8 million infections and 35,000 deaths to 9.7 million and 50,800 is the number most likely to travel. The CDC itself cautions against reading it as a clean trend.

CDC officials say the increase partly reflects real growth in infections from some resistant bacteria and fungi. They also say the agency's data sources and methodology have changed substantially, and that direct comparisons between the two reports should not be made.

Other voices see no reason to play it down. Dr. Wendy Armstrong, president of the Infectious Diseases Society of America, said the numbers "are alarming by any measure but are particularly sobering when infectious diseases physicians connect real patients with these statistics in their everyday experience."

Some of the trend data is firmer than the headline totals. Reported C. auris cases rose more than 50% from 2022 to 2023, the CDC said, a one-year comparison within a single data set.

What the agency and experts are asking for

The report does not announce new funding or a regulatory action. Its asks are practical. Hospitals and long-term care facilities should tighten infection control, and patients should keep up with vaccinations and hand hygiene.

Chiller's ask is about the drug pipeline. "We need more drug development for sure," he said. With resistant C. auris killing up to 62% of the patients it infects and few antifungals available to treat it, the open question is where new drugs will come from.