An epidemiologic survey conducted by the European Centre for Disease Prevention and Control (ECDC) in April 2022 shows Candida auris cases are rising across the continent, researchers reported last week in Eurosurveillance.
The survey shows a near doubling of C auris cases—and countries reporting them—from 2020 to 2021, from 335 reported by 8 countries in 2020 to 655 reported by 13 countries in 2021. In both years, most cases were reported by Spain (260 in 2020 and 331 in 2022) and Italy (49 in 2020 and 242 in 2021). Most of the cases (63.2%) reported in 2020 and 2021 involved colonization, while bloodstream and other type of infections accounted for 15.3% and 10.3% of cases, respectively.
Cases of the multidrug-resistant yeast reported in Europe in 2020 and 2021 were considerably higher than in previous years. Overall, 1,812 C auris cases have been reported by European Union/European Economic Activity (EU/EEA) countries since 2013. But prior to 2021, the number of cases was driven by a large outbreak in one country. Eleven EU/EEA countries had not detected any C auris cases until 2021.
From 2019 to 2021, five countries (Denmark, France, Germany, Greece, and Italy) reported 14 C auris outbreaks—defined as two or more cases with an epidemiologic link. At least two of the reported outbreaks (in Germany and Italy) involved COVID-19 patients or units dedicated to the care of COVID-19 patients. One country (Spain) reported regional endemicity.
The multidrug-resistant yeast, which spreads easily in healthcare settings and can cause severe and deadly infections in patients with compromised immune systems, was first discovered in 2009 in Japan. Since then, it has spread around the world.
"The reported interregional spread as well as regional endemicity in one country show that C. auris is in the process of establishing itself as a healthcare-associated pathogen in the EU/EEA, similar to other countries such as the United States," the authors of the report wrote. "European-level surveillance therefore needs to improve with case definitions and standardised and regular case-based reporting."
The World Health Organization recently listed C auris as one of 19 fungal priority pathogens.