The drug-resistant fungus Candida auris keeps spreading through US hospitals. CDC’s surveillance summary, published in MMWR and covering 2022 through 2024, counted 6,197 clinical cases in 2024 alone, more than double the 2,882 counted in 2022.
Key takeaways
- CDC recorded 13,507 clinical C. auris cases during 2022 to 2024, rising from 2,882 in 2022 to 4,428 in 2023 and 6,197 in 2024.
- Screening swabs found more than twice as many people carrying the fungus as were diagnosed with an infection: 27,853 screening cases over the same three years.
- Nearly all of it happens inside hospitals and long-term acute care hospitals, among patients who are already critically ill.
What happened
CDC’s surveillance summary tracks two separate things. A clinical case means C. auris was found in a specimen collected because a doctor was trying to diagnose an illness. A screening case means it was found on a colonization swab, taken from someone who was not sick from it.
Clinical cases climbed every year, but the rate of climb slowed: up 53.7% from 2022 to 2023, then up 39.9% from 2023 to 2024. Most clinical cases were in adults 45 and older (87.8%) and in men (61.0%). Urine (31.5%) and blood (30.2%) were the most common specimen types.
The setting is narrow. According to the CDC report, 76.6% of clinical cases came from acute care hospitals and 17.8% from long-term acute care hospitals.
Screening cases rose too, from 6,226 in 2022 to 9,195 in 2023 and 12,432 in 2024. The share collected in acute care hospitals climbed from 24.7% in 2022 to 50.7% in 2024, while the long-term acute care share fell from 56.1% to 35.7%.
Dr. Kumar’s take
I operate on patients who spend their recoveries in exactly the places this organism lives: intensive care units, ventilators, central lines, long-term acute care hospitals. So let me draw the line most of this week’s coverage skips.
Colonization is not infection. Roughly two thirds of the C. auris detections CDC logged over those three years were screening swabs from people who were carrying the yeast on their skin without being sick from it. Carriage matters, because it is how the organism moves between patients, but a positive swab is not a diagnosis and it is not a death sentence.
That distinction also explains the frightening death rates that get attached to this fungus in news coverage. The people who develop an invasive C. auris infection are patients who were already on ventilators, already had central lines, already had organ failure. The fungus is a marker of how sick someone was before it ever showed up. Reading those numbers as the fungus’s own kill rate overstates what the data actually shows.
Two more caveats. Reporting to CDC is voluntary from state and jurisdictional health departments, so these counts are a floor, not a census. And the rise in screening inside acute care hospitals means some of the increase reflects hospitals looking harder, not only more fungus. The same pattern runs through CDC’s top antibiotic resistance threats and the 1.27 million deaths a year attributed to bacterial resistance worldwide.
What it means for you
If you are healthy and living your life in the community, this is not your risk. Dr. William Schaffner told Healthline that C. auris “is a growing problem among chronically ill persons in nursing homes and hospitals. It is not a problem among the general public.”
If someone you love is in an ICU or a long-term acute care hospital, the useful questions are practical ones. Ask whether every line and catheter still needs to be there, since urine and blood were the most common sources. Ask whether the facility screens on admission. Insist on hand hygiene from everyone who walks in, including yourself. Basic bedside care still moves the needle on hospital infections, which is why something as small as brushing a patient’s teeth cuts pneumonia risk.
Do not try to self-diagnose this. As Healthline reports, “Some common symptoms include fever and chills, but those are also symptoms of other illnesses.” Diagnosis requires a lab.