The fungus and pathogen Candida auris, which was only discovered a few years ago, is spreading rapidly in Germany. In 2023, it was detected 77 times nationwide – that is six times more often than in previous years, according to an evaluation by the National Reference Center for Invasive Fungal Infections (NRZMyk) based in Jena. The yeast, which was only discovered in 2009, is transmissible between people and is immune to various medications.
“We are currently assuming with a high degree of certainty that this is a real increase in the number of cases and not a ‘better recording’,” said Oliver Kurzai from the Institute for Hygiene and Microbiology at the University of Würzburg, who is also head of the NRZMyk. So far, the reference center is not aware of any deaths in Germany that can be directly attributed to an infection with the yeast fungus. Nevertheless, the fungus is dangerous, especially for people who are previously ill or have a weakened immune system.
According to Kurzai, in addition to bloodstream infections (“fungal sepsis”), infections of prostheses and foreign materials in the body caused by Candida auris are particularly threatening and difficult to treat, such as infections of joint prostheses.
Researchers are pushing for a general reporting requirement
The research team led by Alexander M. Aldejohann from the University of Würzburg published the increase in the number of cases in Germany in the Epidemiological Bulletin of the Robert Koch Institute. Only some of these cases were recorded as part of the reporting requirement introduced in 2023, as this only applies to certain infections. A further increase in the number of cases in Germany must be assumed to be likely; a general reporting requirement for every laboratory detection could slow the spread of the fungus. It also recommends comprehensive tests for Candida auris.
The fungus usually does not affect healthy people. It can become a problem in hospitals and care facilities, especially in intensive care units. Transmission occurs via smear infections. The pathogen does not spread through the air, such as the coronavirus. “If Candida auris gets into your bloodstream, there is a risk of blood poisoning, which is fatal in just over half of all cases,” write the researchers.
Outbreaks mainly in clinics
In 58 of the 77 cases registered in Germany last year, the patients were colonized by the fungus. According to the scientists, an infection occurred in 13 other cases. In 6 cases, the status was unclear. Of the colonized patients or those with an unclear infection status, 5 later developed an invasive infection. The most common infections were wound and tissue infections, bloodstream and catheter-associated infections, and prosthesis infections.
It is said that the increase in Candida auris is primarily due to three outbreaks. “The enormous increase in 2023 surprised us. The decisive factor here is, above all, outbreaks in hospitals. If these are not recognized early and dealt with adequately, they will be very difficult to get under control later,” explained Aldejohann.
The yeast Candida auris, which was only discovered in 2009, has quickly spread internationally. From the beginning, the extremely stubborn pathogen was resistant to some antimycotics – drugs that combat fungal infections – and some disinfectants.
