Candida auris infection increase among EU/EEA countries between 2020 and 2021

In a recent study published in European observationThe researchers evaluated trends in Candida auris Infection among countries of the European Union/European Economic Area (EU/EUA) between 2020 and 2021.

Study: Increase in the number of cases and outbreaks caused by Candida auris in the EU/EEA, from 2020 to 2021. Image credit: Kateryna Kon/Shutterstock
Stady: Increase in the number of cases and outbreaks caused by Candida auris in the EU/EEA, 2020 to 2021. Image credit: Kateryna Kon/Shutterstock

ECDC (European Center for Disease Prevention and Control) has surveyed EU/ERA countries twice to obtain data on epidemiology, laboratory capacity and level of preparedness against Candida auris among EU/EEA countries between 2013 and 2017 and between January 2018 and May 2019. However, the data needed updating after the start of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.

Massive fungal outbreaks in health centers in two Italian regions prompted another Candida auris survey on 4 April 2022 to update data on the epidemiology of Candida auris and mitigation efforts among EU/EEA countries.

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In this study, the researchers evaluated the changing patterns in Candida auris infection among EU/EU countries and presented the pooled results for the three ECDCs. Candida auris Surveys.

National health care facility-related infection contact points and their surrogates were invited to complete the third survey. The survey included 14 questions about the total number of cases Candida auris Infection or transmission and fungal outbreaks documented each year between June 2019 and December 2021. The survey included an option to add Candida auris Retrospective identification of cases between January 2013 and May 2019, detection of national laboratory capacity, and preparedness Candida auris.

Similar questions to the previous ones C. auris Surveys have been added to the third survey, with an additional question about C. auris stages of epidemiology. data about Candida auris Cases obtained between 2013 and 2021 in a standardized format; However, cases detected after the period but of potential clinical relevance, including those with an early identification history from previously known states or new affected states, were also documented. Epidemiological staging of Candida auris Publication based on similar evaluations to those previously reported for multidrug-resistant bacteria such as Enterobacterales (carbapenemase-producing) and Acinetobacter baumannii Carbapenem resistant.


All 30 EU/EEA member states responded to the third survey. Agglomerated data from the three Candida auris surveys showed 1,812 cases Candida auris Injuries were documented by 15 countries between 2013 and 2021. Within a year, C. auris The number of cases has nearly doubled (335 C. auris infections documented by eight countries in 2020, rising to 655 cases documented by 13 countries), and the numbers are much higher than previously reported.

Most of the cases (1146 cases; 63%) were spread by transmission, while 15% (n = 277) and 10% (n = 186) of infection occurred through blood or other routes, respectively. Data on transmission or infection were not available for 11% (n = 203) of cases. No cases of Candida auris infection were detected among the 11 EU/EEA countries before 2021, and national level data on Candida auris infection was not available for four countries. The case is important and states document Candida auris Infections increased, with 13 countries documented C. auris infection in 2021.

Classification data Candida auris Infection such as locally acquired or imported transmission was not available for 97% (n = 1,758) of cases. Available data indicated that one percent (n = 10) and two percent (n = 44) of cases were documented as locally acquired and imported, respectively; However, an import source C. auris Incidences have not been determined due to the paucity of data.

Available data stated that the documented cases originated from African countries (Ethiopia, Egypt, South Africa, and Kenya) and Middle Eastern countries [United Arab Emirates (UAE), Kuwait, and Iraq] and Asian countries (Pakistan and India).

Notably, one case of cross-border transmission was documented as A Candida auris The infection originated in Spain. Between 2019 and 2021, five countries (France, Denmark, Greece, Italy and Germany) documented 14 outbreaks. Candida auris Described as 2 cases with epidemiological links, with a total of 327 individuals affected. The number of individuals affected per Candida auris The outbreak involved two people and 214 individuals. The organism was transported between facilities during eight outbreaks Jim Orris, and three C. auris Outbreaks were ongoing during the third survey.

Only six documented importing countries Candida auris Cases (Phase I), four countries had sporadic cases that were locally acquired or of unknown origin (Phase II), three countries had sporadic outbreaks with or without limited spread between facilities (Phase III), two countries had outbreaks Candida auris With a reasonable or confirmed spread between facilities (Phase IV), one nation C. auris Settlement in certain areas (phase five). During the third survey period, C. auris Transmission or infection has been reported between six countries, 12 countries have established surveillance, and 23 countries have sufficient laboratory capacity to Candida auris detection and testing.

Twelve laboratories used MALDI-TOF MS (Matrix-assisted laser mass spectrometry/ionization time-of-flight) for Candida auris identification, 10 detected the organism by a combination of MALDI-TOF MS and other techniques such as ITS (internal transcription terminator) sequencing while one laboratory only used ITS sequencing for C. auris a statement.

Guidance for infection control and prevention and laboratory testing were documented as being available between 15 and 17 countries, respectively, representing a slight improvement in response and preparedness as of 2019.

In general, the results of the study showed that stimulation of control at the local level Candida auris By establishing the organism in health facilities can benefit at the national level by reducing health care related Candida auris infections in the future.

Therefore, laboratories in EU/EEA countries need sufficient capacity, and sustained monitoring efforts at the national level are required early on. Candida auris Identification and rapid implementation of control and prevention measures.

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