Deadly, drug-resistant fungus spreading in U.S.

In brief

• Candida auris infections have surged from 52 cases in 2016 to over 4,500 in 2023, CDC data shows

• The fungus kills more than 1 in 3 infected and is resistant to many antifungal treatments

• Outbreaks reported in California, Georgia, and Florida as health officials scramble to contain spread.

Details

A dangerous, drug-resistant fungus is spreading rapidly through hospitals and senior care facilities across the U.S., prompting growing concern among public health officials. The yeast, Candida auris (C. auris), poses a serious threat to vulnerable patients and has been linked to a fatality rate as high as 60%, according to the U.S. Centers for Disease Control and Prevention (CDC).

First identified in the U.S. in 2016, when just 52 cases were reported nationwide, the number of infections has exploded — more than doubling each year — reaching 4,514 cases in 2023, the most recent year with available data. California leads the nation with 1,566 confirmed cases, followed by mounting outbreaks in Georgia and Florida.

“The rapid rise and geographic spread of cases is concerning,” said CDC epidemiologist Dr. Meghan Lyman. “It emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and strict infection control.”

A threat to the sick and elderly

C. auris primarily targets people who are already seriously ill, particularly those in intensive care units or long-term care facilities. Individuals with catheters, breathing tubes, or feeding tubes are especially vulnerable because the fungus can easily enter the body through these devices and cause life-threatening bloodstream or organ infections.

“Most of the patients that get infections with Candida auris are themselves pretty sick to start with,” said Dr. Stuart Cohen, chief of infectious diseases at UC Davis. “This is something that can push people over the edge.”

The fungus spreads through direct contact with infected or colonized individuals, as well as contaminated surfaces or medical equipment. Alarmingly, it can survive on surfaces for weeks and is resistant to most common disinfectants. Specialized cleaning products are required to fully eliminate it from healthcare environments.

High death rate, few treatments

Once inside the body, C. auris can cause fever, chills, sepsis, and organ failure. The CDC estimates that 30% to 60% of patients infected with the fungus die, though many have other serious health conditions that contribute to the high fatality rate.

The fungus has been labeled an “urgent threat” by the CDC due to its resistance to multiple antifungal drugs, rapid spread, and severe health impacts.

Hospitals on high alert

In response, many hospitals — especially in California — have begun screening incoming patients from high-risk facilities. If a patient tests positive for C. auris, they are placed in strict isolation to prevent the fungus from spreading.

“The goal is, first and foremost, to keep the people in your hospital safe,” Cohen emphasized. “When somebody comes in for a procedure, they’re not expecting to go home with a life-threatening illness.”

With the fungus now spreading in multiple states, public health officials say early detection, aggressive infection control, and expanded education for healthcare workers are key to containing future outbreaks.

Background on Candida auris

First discovered in 2009 in Japan, Candida auris is a type of yeast that has quickly emerged as a global health concern due to its unusual resistance to antifungal medications and its ability to cause severe, invasive infections. Unlike most other Candida species, C. auris is particularly difficult to identify with standard laboratory methods, often leading to delays in diagnosis and treatment.

One of the most concerning features of C. auris is its ability to persist in healthcare settings and colonize both patients and surfaces, making outbreaks difficult to control.

The fungus can live on skin and objects such as bed rails, doorknobs, and medical devices, allowing it to spread rapidly in hospitals and long-term care facilities. Infections can occur in the bloodstream, wounds, or ears, and colonized individuals may not show symptoms but can still transmit the fungus to others.

Due to its resilience and drug resistance, C. auris has been designated as a serious global health threat by the World Health Organization (WHO) and the CDC, prompting efforts to improve detection, containment, and treatment strategies worldwide.

For more information and prevention guidance, visit www.cdc.gov.