Antibiotic-resistant bacteria are the new normal. Whether it’s super gonorrhea or whatever’s found in surfers’ butts, infections caused by germs that doctors can’t fight with conventional drugs are here to stay. Antibiotic-resistant germs sicken more than 2 million Americans and kill 23,000 Americans each year, reports the U.S. Centers for Disease Control and Prevention. On Tuesday, the agency released the results of its first comprehensive project to track cases of antibiotic resistance, focusing specifically on the most dangerous varieties.

The numbers are sobering. CDC officials report that over nine months in 2017, they observed 221 cases in which patients with various infections — pneumonia, urinary tract infections, bloodstream infections, and others — tested positive for bacteria that exhibit “unusual resistance,” meaning they “are resistant to all or most antibiotics tested and are uncommon or carry special resistance genes.” CDC doctors aren’t mincing words with these superbugs, referring to them as “nightmare bacteria.”

The CDC published these findings in its weekly Vital Signs publication, emphasizing that antibiotic resistance poses an existential threat to modern health and medicine.

Methicillin-Resistant Staphylococcus aureus (MRSA)
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the best-known antibiotic-resistant bacteria, but there are many more out there.

“We don’t just rely on antibiotics to treat common infections,” CDC Principal Deputy Director Anne Schuchat, M.D., told reporters on Tuesday. “Antibiotics are the safety net for most cancer treatments, surgical procedures, ICU care, and organ transplants. Antibiotic resistance threatens this safety net. Today we’re talking about urgent efforts the public health and clinical community are taking to combat antibiotic resistance around the country. There’s good news and bad news to report.”

The bad news is that there’s a rising tide of antibiotic resistance in the U.S., including Vancomycin-resistant Staphylococcus aureus (VRSA), Candida auris, and varieties of “nightmare bacteria” such as carbapenem-resistant Enterobacteriaceae (CRE). In tests performed by the CDC’s national network of antibiotic resistance labs, 25 percent of the 5,776 germs from suspected cases turned out to contain resistance genes that they could pass on to other bacteria. This unique property can make antibiotic resistance spread “like wildfire” since it means that instead of passing traits to offspring, bacteria don’t even have to reproduce to create new resistant bacteria. Instead, they simply pass the resistance trait on to other living bacteria.

More bad news emerged when researchers moved beyond the sick patients and tested the people whom the patients came into contact with at the hospital. They found that 11 percent of these people carried antibiotic-resistant bacteria despite showing no symptoms of infection.

Staphylococcus aureus VISA 2
 Vancomycin-resistant Staphylococcus aureus (VRSA) shows unusual resistance to antibiotics.

“The good news is that we have hard data showing that an aggressive approach works,” says Dr. Schuchat. This aggressive approach refers to the CDC’s rapid response Containment Strategy, which relies on a national network of labs to quickly identify resistant germs so that healthcare facilities that may be experiencing an outbreak can contain it and get it under control as quickly as possible.

“The bottom line is that resistance genes with the capacity to turn regular germs into nightmare bacteria have been introduced into many states, but with an aggressive response we’ve been able to stomp them out promptly and stop their spread between people, between facilities, and between other germs,” says Dr. Schuchat.

While this report sounds frightening, the simple fact is that, on most days, the average person is not at a high risk of contracting one of these nightmare bacteria. For the most part, these unusually resistant bacteria are contracted in healthcare facilities. That being said, the sad reality is that when people test positive for these ridiculously resistant germs, Dr. Schuchat tells reporters, they often don’t survive. In the meantime, the CDC will continue monitoring the spread of antibiotic-resistant nightmare bacteria and figure out the best ways to work with doctors and hospitals to stem outbreaks, something that will certainly continue in the near future.