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The largest outbreak to date of one strain of what authorities have called “nightmare bacteria” is adding to concerns about the spread of such drug-resistant bugs.

The outbreak, centered on a hospital in a Chicago suburb, has infected 44 people in Illinois over the past year, the Centers for Disease Control and Prevention said. The bug, known as carbapenem-resistant enterobacteriaceae, bears a rare enzyme that breaks down antibiotics.

“This is a huge cluster,” said Alex Kallen, a medical officer with the CDC and supervisor for the Illinois outbreak investigation, noting that only 97 cases of the infection have been reported to the agency since 2009.