Drug‑resistant fungus C. auris spreading through European hospitals, ECDC warns

Health officials in Europe have issued an urgent warning after a drug‑resistant fungus, Candida auris (also reported as Candidozyma auris), spread through healthcare facilities and hospitals across the continent, the European Centre for Disease Prevention and Control (ECDC) said in a report released this week. The agency recorded more than 4,000 infections across Europe between 2013 and 2023, including 1,346 cases in 2023 alone, a 67 percent increase from the prior year.

The ECDC said nearly 60 percent of people who contract the infection die within 90 days, and that case numbers, outbreak size and local transmission are increasing in several countries. The infection typically affects critically ill patients and can cause invasive disease in the blood, brain, spinal cord, bones, ears, respiratory system and urinary tract.

C. auris can survive on skin and on surfaces in healthcare settings for extended periods, allowing it to persist on medical equipment and hospital fixtures. Sampling in some British hospitals has detected the organism on items such as medical devices, radiators, windowsills and sinks, the ECDC said. At least 18 countries in Europe have reported cases in the last decade, with Spain, Greece, Italy, Romania and Germany reporting the largest numbers; more recent outbreaks have also been recorded in Cyprus and France.

The fungus was first identified in 2009 in the ear of a patient in Japan and has since been reported on six continents. It has gained notoriety because many strains have developed resistance to the limited antifungal medicines available, making treatment difficult. Global health authorities, including the World Health Organization (WHO), have classified C. auris among high‑priority fungal threats.

"C. auris has spread within only a few years—from isolated cases to becoming widespread in some countries," said Dr. Diamantis Plachouras, head of antimicrobial resistance and healthcare‑associated infections at the ECDC. "But this is not inevitable. Early detection and rapid, coordinated infection control can still prevent further transmission."

Public health officials point to several factors that have contributed to the organism's spread. Inadequate surveillance systems can allow C. auris to establish transmission chains in hospitals without timely detection. Diagnostic delays and the organism's resilience on surfaces further complicate containment. Experts have also noted that rising ambient temperatures may create conditions favorable to fungal growth, though the ECDC said reasons for the recent increase are likely multifactorial.

The consequences of growing antifungal resistance are being felt across healthcare systems. For many years clinicians have relied on a small number of antifungal drug classes; research and regulatory approvals for new antifungals have lagged, in part because fungal cells are biologically similar to human cells, which complicates drug development. Authorities note that only a handful of new antifungal agents have been approved over the past decade.

The ECDC report referenced historical outbreaks that underscore the clinical and operational impacts of C. auris. In 2016, following an outbreak in Spain, the Royal Brompton Hospital in London temporarily closed its intensive care unit after three patients died and roughly 50 others were infected.

In response to the threat, some countries have tightened reporting and infection‑control measures. In the United Kingdom, all confirmed cases of C. auris must be reported to health authorities to improve detection and limit outbreaks. The ECDC emphasized that rapid case identification, coordinated infection‑control procedures, environmental decontamination and appropriate laboratory capacity are central to containment efforts.

Antimicrobial resistance specialists caution that the emergence and spread of drug‑resistant pathogens, including fungi, represent a growing global health challenge. Forecasts cited by health organizations warn that resistance across bacteria, viruses, fungi and parasites could cause millions of additional deaths and substantial health system strain by midcentury if countermeasures are not strengthened.

The ECDC report calls for enhanced surveillance, faster diagnostics, strengthened infection‑prevention practices in healthcare settings and accelerated research into new antifungal treatments. Officials said coordinated national and international action is required to prevent further transmission and protect vulnerable patients in hospitals and long‑term care facilities.

Health systems are advised to review local infection‑control protocols, ensure routine environmental testing where appropriate, and maintain vigilance for C. auris in critically ill patients and in units with recent unexplained infections. The ECDC said timely reporting of cases and information sharing between facilities and public health authorities remain essential to limiting the spread of this resistant organism.