The director of the National Reference Centre for Invasive Fungus Infections, Oliver Kurzai, holding in his hands a petri dish holding the yeast candida auris in a laboratory of Wuerzburg University in Wuerzburg, Germany, 23 January 2018. There has been a recent rise of cases of seriously ill patients becoming infected with the dangerous yeast candida auris. Photo: Nicolas Armer/dpa (Photo by Nicolas Armer/picture alliance via Getty Images)
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Candida auris, a drug-resistant yeast that has spread through American hospitals since its 2016 emergence in the United States, continues to expand its presence. According to a CDC report released on June 30, 2026, clinical infections increased significantly from 2,882 in 2022 to 6,197 in 2024. This yeast often resides harmlessly on the skin of patients in hospitals and long-term care facilities but can lead to fatal bloodstream infections in those with weakened immune systems. It poses a threat because it withstands key antifungal treatments.
Spread, or Better Surveillance?
The report identifies two types of cases: clinical, where the fungus is found in patients suspected of having an infection, and screening, where it is detected through swabs to check for colonization. Both types saw a sharp increase from 2022 to 2024, but these numbers cannot be simply combined as patients may be counted in both categories.
Clinical and screening Candida auris cases reported to the CDC, by year. The two series overlap and cannot be summed: a clinical case is a diagnosed infection, a screening case is colonization found by swab, and one patient can appear as both.
J.M. Drake
Determining whether this rise is due to more frequent infections or increased surveillance is challenging. The surge in reported cases correlates with expanded testing and the classification of screening cases as nationally notifiable in 2023. The CDC acknowledges that it cannot specify how much each of these factors contributes to the overall increase.
One aspect of the data is clearer: about one-third of clinical cases involve blood infections, with the rest detected in urine, wounds, and the respiratory tract. Bloodstream infections are unmistakable and require species identification for treatment. In contrast, yeast in urine or sputum is often noted without distinguishing specifics, and labs are gradually adopting methods to differentiate Candida auris from more common relatives. Blood infection cases rose by about 60% over two years, from 991 to 1,586, while the total clinical cases more than doubled. The proportion of blood cases fell from one-third to one-quarter, indicating that many non-blood specimens reflect colonization rather than severe infection. Thus, the 60% increase in blood cases better represents the growth of invasive disease than the doubling headline suggests.
While totals continue to rise, the year-on-year growth rate is decreasing, from 96% between 2021 and 2022 to 54% and then 40%. The CDC suggests this deceleration might be due to a return to standard infection control practices as pandemic-related strains on resources eased. Though cases are still increasing each year, a slowing rate is expected if control measures are being reestablished.
Resistance is a key concern: nearly all isolates resist fluconazole, and the future danger of Candida auris hinges on whether strains that resist echinocandins or all antifungals remain rare. The current surveillance does not include susceptibility results, leaving this question unanswered.
Screening Moves to the Front Door
Over the past three years, the focus of hospital screening has shifted. Initially, efforts targeted long-term acute care hospitals and ventilator units with high-risk patients. Screening involves swabbing patients to identify carriers and isolate them to prevent the fungus from spreading to others.
Colonization screening for Candida auris by facility type. The search shifted from long-term acute care hospitals to ordinary acute care hospitals, which accounted for half of detections by 2024 as hospitals began screening at admission.
J.M. Drake
In 2022, 56% of screening detections occurred in long-term acute care hospitals, while regular acute care hospitals accounted for 25%. By 2024, these figures had reversed to 36% and 51%, respectively. This likely reflects hospitals beginning to screen patients upon admission, capturing those already colonized elsewhere rather than the fungus spreading between facilities.
The profile of patients remained stable, with nearly 90% being 45 or older and 61% being male. These patients often have extended hospital stays, use ventilators and central lines, and receive heavy antibiotics, all risk factors for colonization. The male predominance remains unexplained across the years studied.
The CDC attributes the slowing spread of infections to the return to basic infection control measures it recommends, such as hand hygiene, patient isolation, and using specific disinfectants effective against the fungus. These practices suffered during the pandemic, leading to a rise in cases. Investigations into resulting outbreaks linked them to shortages of protective gear, lapses in hygiene, and overcrowding in units. Future reductions in cases depend on maintaining these control measures.
