Of the 19 most dangerous pathogens, only six are of great concern to hospitals, hospital infectious disease leaders told Becker’s. And perhaps a larger concern is the lack of new antibiotics.
The CDC’s 2026 “Antimicrobial Resistance Threats Report,” published Oct. 27, estimates the impact of 19 drug-resistant bacterial and fungal pathogens on human health in the U.S. They are categorized into three threat levels. Urgent threats require urgent and aggressive action. Serious threats require prompt and sustained action, and concerning threats require careful monitoring and prevention action, the report said. The CDC also included a watch list of pathogens being monitored because their full burden is not yet understood.
The urgent, serious and concerning pathogen threats result in an estimated 9.7 million infections and 50,800 deaths each year, according to the report. However, most of these pathogens are more of a concern in outpatient settings rather than hospitals, Matthew Sims, MD, PhD, medical director of research and director of infectious diseases research at Royal Oak, Mich.-based Corewell Health William Beaumont University Hospital, told Becker’s.
At the hospital level, the pathogens of most concern are those that spread easily in a facility. The highest concerns for hospital infectious disease leaders are:
- Candida auris
- Carbapenem-resistant Acinetobacter
- Carbapenem-resistant Enterobacterales
- Clostridioides difficile
- Methicillin-resistant Staphylococcus aureus
- Multidrug-resistant Pseudomonas aeruginosa
“Those are the bigger-bucket ones the programs I run try to reduce transmission of,” Tom Talbot, MD, medical director for infection prevention at Nashville, Tenn.-based Vanderbilt Health, told Becker’s. “So those are the handful we think of most in infection prevention and healthcare.”
C. diff and MRSA are reportable to CMS, so they get the most attention nationally, Dr. Talbot said. Infections like CRAB and CRE are far less common, but also have fewer treatment options.
The antibiotic pipeline shrivels
Predictions estimate that by 2050, more people will die every year from antibiotic-resistant infections than from cancer, Dr. Sims said. Many of these infections can be treated with the right antibiotics, but they can only be used in the right circumstances.
“That doesn’t work well for the companies that make them,” he said. “They want you to use their drug and pay for their drug. If we say, ‘We only need this drug when we need this drug, and 95% to 99% of the time we don’t,’ the economics don’t work for pharmaceutical companies. So a lot of pharmaceutical companies got out of making antibiotics, and we’re at the point where we need new antibiotics more than ever.”
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