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On October 27, 2026, the CDC published its first full accounting of drug-resistant germs in seven years. It names 19 bacteria and fungi behind an estimated 9.7 million infections and 50,800 deaths in the United States each year. Infections picked up in hospitals, nursing homes and other medical settings account for more than 42,000 of those deaths and nearly $12 billion in health care costs. “Antimicrobial resistance threatens modern medicine,” CDC Director Erica Schwartz said in a statement. The risk reaches most people through ordinary care, since surgery, chemotherapy and transplants all rely on antibiotics that still work. The jump from the 2.8 million infections counted in the agency’s 2019 report is the one number the CDC says not to read as a trend.
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Why the 2019 numbers cannot be compared
The CDC rebuilt how it counts. Its methods and data sources changed substantially for every pathogen except one, which is why the agency tells readers not to compare the 2026 totals directly with the 2019 and 2013 reports. More than 80 percent of the apparent rise in infections comes from those changes rather than from more illness, according to the CDC. The new estimates rest on 2023 data, aggregated across the 19 urgent, serious and concerning threats. Some of the increase is real, and CDC officials say certain resistant bacteria and fungi are infecting more people than before. One germ is the exception the agency can still track year to year, and it is a fungus.
The four germs the CDC calls urgent threats
Urgent is the top tier, reserved for germs the CDC says need urgent and aggressive action to find infections and stop their spread. Four pathogens sit there: Candida auris, carbapenem-resistant Acinetobacter, carbapenem-resistant Enterobacterales, and drug-resistant Neisseria gonorrhoeae, the bacterium behind gonorrhea. Below them the report places 13 serious threats that need prompt and sustained action, and two concerning threats that need careful monitoring. Carbapenems are last-resort antibiotics, so a germ named for defeating them is a problem by definition. Candida auris is the only fungus in the top tier. In 2019, laboratories confirmed just under 480 clinical cases of it in the United States.
Candida auris cases climbed nearly tenfold since 2019
By 2023 that count had reached 4,523 clinical cases, including a jump of more than 50 percent from 2022 alone. C. auris is the only pathogen in the report that the CDC says can be compared across editions, because the way it is tracked did not change. The fungus was first reported in the United States in 2016, and cases have climbed every year since. Some strains resist all three available classes of antifungal drugs, and there are far fewer antifungals to fall back on than antibiotics. Tom Chiller, former chief of the CDC’s Mycotic Diseases Branch, has said resistant C. auris infections are fatal in 29 to 62 percent of patients. Many of the people carrying it never feel sick.
How the fungus moves through hospitals and nursing homes
People can carry C. auris on their skin without symptoms and leave it on bed rails, carts and other surfaces, the CDC says, which is how one case becomes a ward outbreak. It can cause anything from a mild skin infection to a bloodstream infection. The highest risk falls on people who spend long stretches in hospitals or long-term care and who have devices crossing the skin, such as breathing tubes, feeding tubes and catheters. The same is true of the two carbapenem-resistant bacteria in the urgent group, so for three of the four urgent threats the real exposure is time spent in medical care. The fourth is caught somewhere else entirely.
Drug-resistant gonorrhea keeps its place on the list
Neisseria gonorrhoeae is the one urgent threat most people would meet outside a hospital. Gonorrhea spreads through sex, often without symptoms, and the bacterium has defeated one antibiotic after another over the decades, which is why CDC treatment guidance leans on a single injectable drug, ceftriaxone. That narrow margin is why the germ held its urgent rating in the 2026 report. The infections are common, testing often lags behind transmission, and there is little left to switch to if the last reliable drug fails. Two more germs in the urgent group are the ones hospital staff call nightmare bacteria.
Nightmare bacteria surged on one specific gene
Carbapenem-resistant Enterobacterales, a family that includes some strains of E. coli and Klebsiella, is what hospital staff mean by nightmare bacteria. A CDC analysis published in Annals of Internal Medicine in September 2025 found that carbapenemase-producing CRE rose 69 percent between 2019 and 2023, and that nearly all of the growth came from one type, NDM-CRE, which jumped more than 460 percent. Of 4,341 cases reported through the CDC’s laboratory network in 2023, 1,831 were the NDM kind. The enzyme behind it blocks nearly every approved antibiotic, and many clinical laboratories cannot test for it, so the correct diagnosis often arrives late. One germ from the 2019 urgent list has since moved down a tier.
C. diff moved down and meningococcal moved up
Clostridioides difficile, the gut infection that often follows a course of antibiotics and can inflame the colon dangerously, was an urgent threat in 2019. In the 2026 report it sits among the serious threats, because infection rates fell and then held steady, one of the few pieces of good news in the document. Drug-resistant Neisseria meningitidis went the other way and has been raised to a serious threat. It causes meningitis and bloodstream infections that can turn fatal within hours, which is what makes resistance in this particular germ so consequential. Six more germs sit outside the three tiers entirely, and one of them causes ringworm.
Six watch list germs the CDC is monitoring
The watch list covers pathogens whose national burden the CDC says is not yet understood. It includes drug-resistant dermatophytes, the fungi behind ringworm, which usually clear with over-the-counter antifungal creams but have developed resistance in some strains in the United States and abroad. Misusing those creams, or using combined steroid and antifungal products, may be feeding that resistance, the CDC says. Also on the list are drug-resistant Haemophilus influenzae, which can cause anything from an ear infection to pneumonia or meningitis, and the bacterium behind whooping cough. If macrolide resistance in that germ becomes common, the CDC says, infections could turn more severe, particularly in young children. Hip and knee replacements are the part of this that worries infectious disease specialists.
What resistance means for routine medical care
Resistant infections lengthen hospital stays, raise costs and make common procedures riskier, said Wendy Armstrong, president of the Infectious Diseases Society of America. The people this touches are ordinary: patients on chemotherapy, transplant recipients and anyone having a hip or knee replaced, because all of that care assumes an antibiotic will stop an infection if one starts. The report itself has changed shape to match. The CDC replaced the old downloadable document with a website, arthreats.cdc.gov, carrying a page for each of the 19 threats and the six on the watch list. It is the place to check what the agency knows about a specific germ.