Candida auris as an Emergent Public Health Problem: A Current Update on European Outbreaks and Cases

Abstract

Candida auris is considered to be an emerging fungal pathogen and is related to high mortality rates, persistent candidemia, inconsistencies in susceptibility testing results and misidentification by available commercial identification systems. Multidrug-resistant (MDR) and pandrug-resistant (PDR) strains are increasingly detected. In Europe, hospital outbreaks caused by C. auris have been reported in the United Kingdom (UK), Italy and Spain; however, several cases have been sporadically detected in all European countries. C. auris is difficult to control despite enhanced control measures due to its ability to survive for a long time in environments and colonize patients for prolonged periods. An adequate laboratory diagnostic capacity and national surveillance are fundamental to rapidly detect new C. auris cases and to apply the correct measures to circumscribe them and prevent their spread. Our narrative review aims to highlight the primary C. auris outbreaks and case reports that have occurred in Europe.

Keywords: Candida auris; emerging fungal disease; infectious disease prevention; public health promotion.

Figure 1

Candida isolates from Brilliance™ Candida Agar Base (Thermo Fisher Scientific^TM, Waltham, MA, USA). C. auris (light blue with blue halo colonies), C. krusei (pink and fuzzy colonies) and C. albicans (green–blue colonies).

Figure 2

Spanish C. auris cases from 2013 to 2021 [33].

Figure 3

Principal cases of C. auris in Europe. In red: detected C. auris outbreak countries with inter-facility spreading or endemicity (Spain, Italy, Greece and the UK). In light yellow: country (Germany, France and Denmark) with sporadic outbreaks without or with only limited inter-facility spreading. In light blue: sporadic C. auris cases that were locally acquired or an unknown or imported origin [17,32,38].