'Superbugs' surge to record levels in Korea, with infections near 45,000

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Infections caused by carbapenem-resistant Enterobacterales — one of the most feared antibiotic-resistant “superbugs” — are rising at the fastest pace ever recorded in South Korea, with this year's cases already having surpassed last year’s total.

According to the Korea Disease Control and Prevention Agency, 44,930 CRE infections had been reported as of Dec. 1, a 6.1 percent increase from the 42,347 cases documented in all of 2024. This marks the highest figure since nationwide monitoring began in 2018, with consistent upward trend observed in the past seven years.

CRE infections occur when Enterobacterales, a common family of gut bacteria, develop resistance to carbapenems, a class of antibiotics considered one of the last lines of defense.

Since CRE became part of mandatory nationwide surveillance in June 2017, cases have risen steadily each year: from 5,717 reports in 2017 to 11,954 in 2018, 15,369 in 2019, 18,113 in 2020, 23,311 in 2021, 30,548 in 2022 and 38,405 in 2023.

Health authorities say the surge shows how the fight against infectious disease has fundamentally shifted.

“The era when we only worried about new pathogens is already over,” one orthopedics expert said. “Drug-resistant bacteria are transforming the future landscape of infectious disease.”

The data reveals alarming vulnerabilities in senior and long-term care populations. Patients aged 60 and older accounted for 86.3 percent of all reported CRE cases. Those 70 and older accounted for more than 31,000 infections, highlighting the intersection between Korea’s rapid aging and rising antimicrobial resistance.

Experts say that nursing hospitals, long-term care institutions and other high-risk facilities remain structurally weak points in infection control, allowing CRE to spread quietly among immunocompromised patients.

Patients in health care settings are at most risk for CRE. Bacteria typically spread in health care settings through direct or indirect contact with infected patients or contaminated equipment. Antibiotic misuse is a key driver of resistance, and once infected, patients often face limited treatment options.

Health authorities warn that CRE infections not only prolong hospitalization and raise treatment costs, but also pose growing socioeconomic risks.

The World Health Organization classified antimicrobial resistance as one of the top 10 global public health threats in 2019.

In response, the KDCA said it is preparing the Third National Antimicrobial Resistance Management Plan for 2026-2030, aimed at reducing antibiotic use, preserving treatment effectiveness and strengthening infection prevention. The plan is expected to be finalized later this month.

South Korea remains among the highest antibiotic-consuming nations in the Organization for Economic Cooperation and Development. As of 2023, the country recorded 31.8 defined daily doses per 1,000 people, the second-highest level among 34 member countries with available data and significantly above the OECD average of 18.3 defined daily doses.