NDHN Special Report — Antimicrobial Resistance (AMR)
Wednesday, October 29th, 2025
Executive Summary: AMR is accelerating globally while the U.S. faces a sharp rise in NDM‑CRE; leaders should act now on surveillance, IPC, stewardship, and diagnostics.
Global & Health Sector News
- WHO: One in six lab‑confirmed bacterial infections in 2023 were resistant; resistance rose in over 40% of pathogen‑antibiotic pairs (2018–2023) — https://www.who.int/news/item/13-10-2025-who-warns-of-widespread-resistance-to-common-antibiotics-worldwide
- WHO pipeline reports: only 90 antibacterials in clinical development in 2025 (down from 97 in 2023); few innovative agents — https://www.who.int/news/item/02-10-2025-who-releases-new-reports-on-new-tests-and-treatments-in-development-for-bacterial-infections
- WHO upgrades EIOS (open‑source epidemic intelligence) to improve near‑real‑time detection of threats including AMR — https://www.who.int/news/item/13-10-2025-who-upgrades-its-public-health-intelligence-system-to-boost-global-health-security
U.S. Industry & Policy Updates
- CDC: >460% increase (2019–2023) in New Delhi metallo‑β‑lactamase (NDM) producing CRE infections in the U.S. — https://www.cdc.gov/media/releases/2025/2025-cdc-report-finds-sharp-rise-in-dangerous-drug-resistant-bacteria.html
- MMWR (NYC): NDM‑positive CRE rose from 58 cases (2019) to 388 (2024), surpassing KPC‑positive CRE — https://www.cdc.gov/mmwr/volumes/74/wr/mm7423a2.htm
- CDC HAI Progress Report (2023 vs 2022): CLABSI −13%, CAUTI −11%, VAE −5%, MRSA −16%, CDI −13% — https://www.cdc.gov/healthcare-associated-infections/php/data/progress-report.html
Quality Metrics to Share with Your Team (≤7)
1. Global AMR burden: 1 in 6 lab‑confirmed bacterial infections resistant (2023); >40% of monitored pairs rising since 2018 — https://www.who.int/news/item/13-10-2025-who-warns-of-widespread-resistance-to-common-antibiotics-worldwide
2. U.S. NDM‑CRE surge: >460% increase 2019→2023 across 29 reporting states — https://www.cdc.gov/media/releases/2025/2025-cdc-report-finds-sharp-rise-in-dangerous-drug-resistant-bacteria.html
3. Pipeline scarcity: only 90 antibacterials in clinical trials in 2025 (down from 97 in 2023); few truly innovative — https://www.who.int/news/item/02-10-2025-who-releases-new-reports-on-new-tests-and-treatments-in-development-for-bacterial-infections
4. HAI trend (2023 vs 2022): CLABSI −13%, CAUTI −11%, VAE −5%, MRSA −16%, CDI −13% — https://www.cdc.gov/healthcare-associated-infections/php/data/progress-report.html
5. NYC NDM‑CRE: 58 cases (2019) → 388 (2024); NDM surpassed KPC — https://www.cdc.gov/mmwr/volumes/74/wr/mm7423a2.htm
6. WHO target: 10% reduction in deaths associated with AMR under 2025–2035 strategy framework — https://cdn.who.int/media/docs/default-source/antimicrobial-resistance/amr-gcp-asa/global-call-to-action-to-address-amr---oct-2025.pdf?download=true&sfvrsn=62dfd2f6_2
7. Diagnostics & innovation gap: only 5 candidates effective against at least one ‘critical’ pathogen in 2025 analysis — https://www.who.int/news/item/02-10-2025-who-releases-new-reports-on-new-tests-and-treatments-in-development-for-bacterial-infections
Strategic Implications for Leadership
- Strengthen detection capacity: ensure rapid carbapenemase testing (incl. NDM) and participate in state GLASS/NHSN reporting — https://www.cdc.gov/media/releases/2025/2025-cdc-report-finds-sharp-rise-in-dangerous-drug-resistant-bacteria.html
- Sustain IPC bundles in high‑risk units to maintain HAI reductions as AMR risk rises — https://www.cdc.gov/healthcare-associated-infections/php/data/progress-report.html
- Invest in diagnostics and stewardship (IV‑to‑PO, 48–72 hr time‑outs, de‑escalation, OPAT criteria) to slow resistance and shorten LOS — https://www.who.int/news/item/02-10-2025-who-releases-new-reports-on-new-tests-and-treatments-in-development-for-bacterial-infections
- Track AMR KPIs on the board dashboard; align with WHO’s 2025–2035 targets and local public health strategy — https://cdn.who.int/media/docs/default-source/antimicrobial-resistance/amr-gcp-asa/global-call-to-action-to-address-amr---oct-2025.pdf?download=true&sfvrsn=62dfd2f6_2
Leadership Actions (≤5)
- Stand up an AMR ‘rapid response’ playbook: STAT carbapenemase PCR (incl. NDM), Enhanced Barrier Precautions, and ID consult within 2 hours for suspected CRE — https://www.cdc.gov/media/releases/2025/2025-cdc-report-finds-sharp-rise-in-dangerous-drug-resistant-bacteria.html
- Launch a stewardship ‘sprint’: empiric therapy guardrails, 48–72‑hour time‑outs, de‑escalation protocols, and OPAT criteria review — https://www.who.int/news/item/02-10-2025-who-releases-new-reports-on-new-tests-and-treatments-in-development-for-bacterial-infections
- Upgrade lab capacity: verify carbapenemase panels (NDM/KPC/OXA‑48/VIM/IMP), MALDI‑TOF uptime, and reflex pathways; close gaps via partner labs — https://www.cdc.gov/mmwr/volumes/74/wr/mm7423a2.htm
- Brief the board/C‑suite on AMR metrics monthly; set FY2026 targets tied to IPC bundle adherence and rapid diagnostics adoption — https://www.cdc.gov/healthcare-associated-infections/php/data/progress-report.html
- Engage payers and public health: align funding for diagnostics and isolation resources; participate in regional AMR networks — https://www.who.int/news/item/13-10-2025-who-warns-of-widespread-resistance-to-common-antibiotics-worldwide
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