Drug-resistant fungus spreads rapidly across European hospitals

The European Centre for Disease Prevention and Control has reported a sharp rise in cases of Candidozyma auris across Europe, a multidrug-resistant fungus that threatens hospital patients and healthcare systems, with outbreaks reported to be widespread in across several countries within the European Union 

The European Centre for Disease Prevention and Control (ECDC) has reported that the multidrug-resistant fungus Candidozyma auris – formerly known as Candida auris – continues to be spreading rapidly across hospitals in Europe, creating a growing threat to patients and healthcare systems.

In the European Union’s agency’s fourth survey of the pathogen, it has found that case numbers have risen sharply, outbreaks have expanded in scale, and several countries have reported sustained local transmission. Between 2013 and 2023, more than 4,000 cases were identified across EU and European Economic Area states. A record 1,346 cases were recorded in 2023 alone, reported by 18 countries. Spain, Greece, Italy, Romania and Germany accounted for the majority of cases during the past decade.

“C. auris has spread within only a few years – from isolated cases to becoming widespread in some countries. This shows how rapidly it can establish itself in hospitals,” said Dr Diamantis Plachouras, Head of ECDC’s Antimicrobial Resistance and Healthcare-Associated Infections Section.

“But this is not inevitable. Early detection and rapid, coordinated infection control can still prevent further transmission.”

In a press conference conducted online, a spokesperson for the ECDC confirmed that “in the agency’s” experience neither patients, or wider populations, would build immunity – as might be seen in the case of a viral pandemic – nor was there any established treatment methodology by which a patient can recover from infection by the fungus. In their view once a patient has a colony of C. auris established itself in a patient this becomes permanent.

Outbreaks have recently been documented in Cyprus, France and Germany, while in Greece, Italy, Romania and Spain the pathogen has spread so extensively that it is no longer possible to distinguish individual outbreaks. Sustained local transmission has developed within only a few years of the first cases in several countries, underlining the urgency of early intervention.

Despite some successes in containing outbreaks, only 17 of the 36 countries surveyed have established a national surveillance system for C. auris, and only 15 have developed national infection-prevention guidance. Laboratory capacity is stronger, with 29 countries reporting access to a mycology reference laboratory, although gaps remain in reference testing and mandatory reporting. The ECDC has cautioned that the true burden of infection is likely under-reported.

ECDC officials emphasised that C. auris spreads easily in healthcare facilities, resists many antifungal drugs, and can persist on surfaces and medical equipment. Without effective surveillance, early detection and rigorous infection control, the agency warned that outbreaks are likely to escalate further.

Looking to the United Kingdom has recorded 637 cases since the first detection in 2013, with 178 confirmed in 2024 alone. Most outbreaks have occurred in tertiary centres near London and other international travel hubs, often linked to patients repatriated from South Asia, the Middle East and Africa. The UK Health Security Agency has designated C. auris as a notifiable infection and strengthened surveillance.

And in the United States, the pathogen has become endemic in some regions. The Centres for Disease Control and Prevention (CDC) has classified it as an ‘urgent antimicrobial resistance threat’, with more than 4,000 clinical cases reported in 2023. Resistance to echinocandins – the preferred antifungal treatment – has increased, further complicating management.