European health authorities are sounding the alarm over the rapid spread of the Multidrug-Resistant Candida Auris, which is increasingly being detected in hospitals across the continent. A recent survey by the European Centre for Disease Prevention and Control (ECDC) shows that more than half of the 4,012 cases reported in the European Union and European Economic Area (EU/EEA) between 2013 and 2023 occurred during just the past two years.
Spain, Greece, Italy, Romania, and Germany reported the largest number of infections. In several of these countries, outbreaks are now so widespread that health officials can no longer distinguish between individual hospital clusters.
A Deadly and Hard-to-Treat Pathogen
First identified in Japan in 2009, C. auris has spread worldwide, infecting critically ill and immune-compromised patients. The yeast has been designated a “fungal priority pathogen” by the World Health Organization due to its ability to cause severe bloodstream infections with high mortality rates—estimated between 29% and 62%.
The danger lies not only in its virulence but also in its resistance to treatment. While most strains are resistant to fluconazole, many have also shown reduced susceptibility to echinocandins and amphotericin B, two other major antifungal classes. Hospitals have faced particular difficulty eradicating the fungus, as it can survive for months on surfaces such as bed rails, curtains, and medical equipment, even after standard cleaning.
Multidrug-Resistant Candida Auris has spread within only a few years—from isolated cases to becoming widespread in some countries,” said Diamantis Plachouras, MD, PhD, who leads the ECDC’s Antimicrobial Resistance and Healthcare-Associated Infections section. “This shows how rapidly it can establish itself in hospitals.”
Cases Surge, Preparedness Lags
The 2024 ECDC survey, the fourth conducted since the fungus was first detected in Europe, highlights the accelerating trend. A record 1,346 cases were reported by 18 countries in 2023 alone, with Cyprus, France, and Germany each noting distinct outbreaks that year.
Spain, which reported Europe’s first hospital outbreak in 2016, remains the hardest hit, with 1,807 cases over the past decade. Greece and Italy reported 852 and 712 cases, respectively. The ECDC noted that within just five to seven years of initial detection, these countries progressed to widespread hospital transmission, underscoring the pathogen’s ability to embed itself in healthcare networks.
Despite the alarming rise, significant gaps remain in national preparedness. Only 17 of the 36 countries surveyed currently maintain a national surveillance system for Multidrug-Resistant Candida Auris , and just 15 have issued specific infection prevention and control (IPC) guidelines. The ECDC stressed that expanding surveillance and enforcing IPC measures are essential to delay further spread and reduce risks for vulnerable patients.
Global Concerns and Outlook
The problem is not confined to Europe. In the United States, 4,514 new Multidrug-Resistant Candida Auris cases were reported in 2023, according to the Centers for Disease Control and Prevention. Health experts there are preparing new recommendations to help clinicians address rising antifungal resistance and improve patient outcomes.
ECDC officials warn that without urgent and coordinated action, C. auris could continue to overwhelm hospitals. “This rapid dissemination is of serious concern and points to a high risk for continued spread throughout European healthcare systems,” the agency stated.
With the pathogen’s persistence in hospital environments, limited treatment options, and growing prevalence, experts agree that strengthening surveillance, early detection, and infection control strategies will be critical to containing one of the most pressing fungal threats of the decade.
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