The latest survey from the European Centre for Disease Prevention and Control (ECDC), the fourth of its kind, confirms that Candidozyma auris (formerly Candida auris) continues to spread quickly across European hospitals, posing a serious threat to patients and healthcare systems. Case numbers are rising, outbreaks are growing in scale, and several countries report ongoing local transmission. The findings highlight the importance of early detection and control of transmission to avoid widespread rapid dissemination.
Candidozyma auris (C. auris) is a fungus that usually spreads within healthcare facilities, is often resistant to antifungal drugs, and can cause severe infections in seriously ill patients. Its ability to persist on different surfaces and medical equipment and to spread between patients makes it particularly challenging to control. Between 2013 and 2023, EU/EEA countries reported over 4 000 cases, with a significant jump to 1 346 cases reported by 18 countries in 2023 alone. Five countries – Spain, Greece, Italy, Romania, and Germany – have accounted for most of the cases over the 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,” he added. “Early detection and rapid, coordinated infection control can still prevent further transmission.”
Recent outbreaks have been reported in Cyprus, France and Germany, while Greece, Italy, Romania and Spain have indicated they can no longer distinguish specific outbreaks due to widespread regional or national dissemination. In several of these countries, sustained local transmission has occurred within only a few years after the first documented case, highlighting a critical window for early interventions to stop its spread.
While some countries have showed positive results in limiting C. auris outbreaks, many are facing key gaps. Despite rising case numbers, only 17 of 36 participating countries currently have a national surveillance system in place for C. auris. Only 15 countries have developed specific national infection prevention and control guidance. Laboratory capacity is comparatively stronger, with 29 countries reporting access to a mycology reference or expert laboratory and 23 offering reference testing for hospitals.
While the number of C. auris infections is clearly rising, without systematic surveillance and mandatory reporting, the true scale of the problem is likely under-reported.
ECDC has regularly assessed the epidemiological situation, laboratory capacity and preparedness for C. auris in four surveys since 2018 and published rapid risk assessments including options for infection prevention and control. This is to support Member States in improving their preparedness and early response capacities to prevent or contain C. auris outbreaks in a timely manner and prevent further transmission.
Notes to the editor
- The C. auris 2024 survey covered 36 countries, including EU/EEA countries and EU enlargement countries in the Western Balkans and Türkiye.
- Spain (1 807), Greece (852), Italy (712), Romania (404) and Germany (120) reported the highest number of cases between 2013 and 2023.
- In 2023, 1 346 cases were reported by 18 EU/EEA countries, the highest number since C. auris was first reported in Europe in 2014.